Abstract
OBJECTIVE--To compare prescribing patterns between a group of fundholding practices and a group of non-fundholding practices in north east Scotland using a method which provides more accurate statements about volumes prescribed than standard NHS statistics. DESIGN--The pharmacy practice division of the National Health Service in Scotland provided data for selected British National Formulary sections over two years. Each prescription issued was converted using the World Health Organisation "defined daily dose" mechanism. SETTING--Six fundholding groups (nine practices) in Grampian and Tayside regions and six non-fundholding practices in Grampian. RESULTS--During the past two years both fundholding and control practices reduced the volume of their prescribing for the classes of drug analysed. The unit costs of drugs in some classes, however, rose substantially, contributing to higher costs per patient. The unit costs rose more in the control practices (24%) than in the fundholding practices (11% in Tayside, 16% in Grampian). CONCLUSION--The use of defined daily doses helped identify cost and volume trends in specific areas of prescribing in fundholding and control practices. The basis on which funds are set needs improving, and defined daily doses may prove useful for setting volume targets within drug classes for all practices, whether fundholding or not.
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Selected References
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- Bain J. Budget holding in Calverton: one year on. BMJ. 1992 Apr 11;304(6832):971–973. doi: 10.1136/bmj.304.6832.971. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bain J. The new NHS: the second year. Budget holding: here to stay? BMJ. 1993 May 1;306(6886):1185–1188. doi: 10.1136/bmj.306.6886.1185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coulter A., Bradlow J. Effect of NHS reforms on general practitioners' referral patterns. BMJ. 1993 Feb 13;306(6875):433–437. doi: 10.1136/bmj.306.6875.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Howie J. G., Heaney D. J., Maxwell M., Porter A. M., Hopton J. L., Light C. J. The chief scientist reports ... The Scottish general practice shadow fund-holding project--outline of an evaluation. Health Bull (Edinb) 1992 Jul;50(4):316–328. [PubMed] [Google Scholar]
- Howie J. G., Heaney D. J., Maxwell M. The chief scientist reports ... Evaluation of the Scottish shadow fund-holding project: first results. Health Bull (Edinb) 1993 Mar;51(2):94–105. [PubMed] [Google Scholar]
- Newton J., Fraser M., Robinson J., Wainwright D. Fundholding in northern region: the first year. BMJ. 1993 Feb 6;306(6874):375–378. doi: 10.1136/bmj.306.6874.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Purves I. N., Edwards C. Comparison of prescribing unit with index including both age and sex in assessing general practice prescribing costs. BMJ. 1993 Feb 20;306(6876):496–498. doi: 10.1136/bmj.306.6876.496. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sleator D. J. Towards accurate prescribing analysis in general practice: accounting for the effects of practice demography. Br J Gen Pract. 1993 Mar;43(368):102–106. [PMC free article] [PubMed] [Google Scholar]
- Wyatt T. D., Passmore C. M., Morrow N. C., Reilly P. M. Antibiotic prescribing: the need for a policy in general practice. BMJ. 1990 Feb 17;300(6722):441–444. doi: 10.1136/bmj.300.6722.441. [DOI] [PMC free article] [PubMed] [Google Scholar]