Literature DB >> 16882380

The relationship between prescribing expenditure and quality in primary care: an observational study.

Robert Fleetcroft1, Richard Cookson.   

Abstract

BACKGROUND: If all GPs target their prescribing appropriately, then a positive relationship may be expected between targeting quality indicators and associated prescribing expenditure. Little is known about this relationship. AIM: To explore the relationship between prescribing quality indicators and associated prescribing expenditures.
DESIGN: Observational study of prescribing expenditure and quality indicators.
SETTING: Seventy-one of the 121 practices in the Norfolk and Waveney area of East Anglia in England.
METHOD: Data were collected on quality indicators for 2002-2003 in seven areas likely to produce the greatest number of lives saved over a period of 1 year. This was linked to routine data on associated pharmaceutical expenditure.
RESULTS: There was considerable variation in quality in all areas apart from influenza immunisation. Significant correlations between prescribing quality and expenditure were found in only two of the seven areas. When quality scores were combined into a composite quality index weighted by health gain, a small positive association was found, but this association is lost if all indicators are weighted equally.
CONCLUSIONS: There appeared to be no relationship between quality indicators and prescribing expenditure at the practice level for most of the therapeutic areas studied. This suggests the possibility that there may be scope for some GPs to target prescribing more appropriately towards high risk patients -- and thus save more lives -- without increasing prescribing expenditure.

Entities:  

Mesh:

Year:  2006        PMID: 16882380      PMCID: PMC1874526     

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN: 0960-1643            Impact factor:   5.386


  6 in total

1.  Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis.

Authors:  N Rice; P Dixon; D C Lloyd; D Roberts
Journal:  BMJ       Date:  2000-01-29

Review 2.  Assessment of dependence and motivation to stop smoking.

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3.  Quality incentives: the case of U.K. general practitioners.

Authors:  Peter C Smith; Nick York
Journal:  Health Aff (Millwood)       Date:  2004 May-Jun       Impact factor: 6.301

4.  Do the incentive payments in the new NHS contract for primary care reflect likely population health gains?

Authors:  Robert Fleetcroft; Richard Cookson
Journal:  J Health Serv Res Policy       Date:  2006-01

5.  Primary care groups and the right to prescribe.

Authors:  C Newdick
Journal:  BMJ       Date:  1998-11-14

Review 6.  Performance indicators for primary care groups: an evidence based approach.

Authors:  A McColl; P Roderick; J Gabbay; H Smith; M Moore
Journal:  BMJ       Date:  1998-11-14
  6 in total
  4 in total

1.  Correlation between prescribing quality and pharmaceutical costs in English primary care: national cross-sectional analysis.

Authors:  Robert Fleetcroft; Richard Cookson; Nicholas Steel; Amanda Howe
Journal:  Br J Gen Pract       Date:  2011-09       Impact factor: 5.386

2.  Compliance with quality prescribing indicators linked to financial incentives: what about not incentivized indicators?: an observational study.

Authors:  R Fernández Urrusuno; P Pérez Pérez; M C Montero Balosa; C Márquez Calzada; B Pascual de la Pisa
Journal:  Eur J Clin Pharmacol       Date:  2013-12-03       Impact factor: 2.953

3.  The UK pay-for-performance programme in primary care: estimation of population mortality reduction.

Authors:  Robert Fleetcroft; Sheetal Parekh-Bhurke; Amanda Howe; Richard Cookson; Louise Swift; Nicholas Steel
Journal:  Br J Gen Pract       Date:  2010-09       Impact factor: 5.386

4.  Achievement of cholesterol targets and prescribing of higher-cost statins: a cross-sectional study in general practice.

Authors:  Robert Fleetcroft; Peter Schofield; Martin Duerden; Mark Ashworth
Journal:  Br J Gen Pract       Date:  2012-12       Impact factor: 5.386

  4 in total

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