Investigating Impacts of Health Policies Using Staggered Difference-in-Differences: The Effects of Adoption of an Online Consultation System on Prescribing Patterns of Antibiotics

We use a recently proposed staggered difference-in-differences approach to investigate effects of adoption of an online consultation system in English general practice on antibiotic prescribing patterns. The target estimand is the average effect for each group of practices (defined by year of adoption) in each year, which we aggregate across all adopting practices, by group, and by time since adoption. We find strong evidence of a positive effect of adoption on antibiotic prescribing rates, though the magnitude of effect is relatively small. As time since adoption increases, the effect size increases, while effects vary across groups.