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. 1993 Jun 26;306(6894):1731–1734. doi: 10.1136/bmj.306.6894.1731

Explaining variations in prescribing costs across England.

T Morton-Jones 1, M Pringle 1
PMCID: PMC1678321  PMID: 8343631

Abstract

OBJECTIVE--To derive a predictive model for national prescribing behaviour in terms of basic morbidity and demographic factors. DESIGN--24 demographic, morbidity, and practice factors were entered into a multiple regression analysis to determine the net ingredient cost per patient. SETTING--The 90 family health service authorities in England for 1989. RESULTS--For net ingredient cost per patient only two demographic factors (numbers of pensioners and the mobility of the registered population measured by list inflation) and two morbidity related factors (standardised mortality ratios and numbers of prepayment certificates issued) significantly contributed to a multiple regression model. This model explained 81% of the variation in net ingredient cost per registered patient between family health services authorities. The model also enabled a weighting factor of 4.6 (95% confidence interval 3.2 to 6.7) to be derived for the net ingredient cost for elderly patients (compared with the existing prescribing unit factor of 3). CONCLUSIONS--The model shows that variations in prescribing costs essentially reflect demand. It also suggests that the current prescribing unit value of 3 for patients aged 65 or more underestimates the extra costs of prescribing for elderly patients.

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Selected References

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  1. Baker D., Klein R. Explaining outputs of primary health care: population and practice factors. BMJ. 1991 Jul 27;303(6796):225–229. doi: 10.1136/bmj.303.6796.225. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bradley C. P. Decision making and prescribing patterns--a literature review. Fam Pract. 1991 Sep;8(3):276–287. doi: 10.1093/fampra/8.3.276. [DOI] [PubMed] [Google Scholar]
  3. Brennan M. E., Clare P. H. The relationship between mortality and two indicators of morbidity. J Epidemiol Community Health. 1980 Jun;34(2):134–138. doi: 10.1136/jech.34.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Forster D. P., Frost C. E. Use of regression analysis to explain the variation in prescribing rates and costs between family practitioner committees. Br J Gen Pract. 1991 Feb;41(343):67–71. [PMC free article] [PubMed] [Google Scholar]
  5. Marinker M. The doctor's role in prescribing. J R Coll Gen Pract. 1973 Jun;23 (Suppl 2):26–30. [PMC free article] [PubMed] [Google Scholar]
  6. Mays N., Chinn S., Ho K. M. Interregional variations in measures of health from the Health and Lifestyle Survey and their relation with indicators of health care need in England. J Epidemiol Community Health. 1992 Feb;46(1):38–47. doi: 10.1136/jech.46.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Mays N., Chinn S. Relation between all cause standardised mortality ratios and two indices of deprivation at regional and district level in England. J Epidemiol Community Health. 1989 Jun;43(2):191–199. doi: 10.1136/jech.43.2.191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Morton-Jones T. J., Pringle M. A. Prescribing costs in dispensing practices. BMJ. 1993 May 8;306(6887):1244–1246. doi: 10.1136/bmj.306.6887.1244. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Taylor R. J., Bond C. M. Change in the established prescribing habits of general practitioners: an analysis of initial prescriptions in general practice. Br J Gen Pract. 1991 Jun;41(347):244–248. [PMC free article] [PubMed] [Google Scholar]
  10. Taylor R. J. General-practitioner prescribing. J R Coll Gen Pract. 1977 Feb;27(175):79–82. [PMC free article] [PubMed] [Google Scholar]
  11. Virji A., Britten N. A study of the relationship between patients' attitudes and doctors' prescribing. Fam Pract. 1991 Dec;8(4):314–319. doi: 10.1093/fampra/8.4.314. [DOI] [PubMed] [Google Scholar]

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