McCarthy M, Wilson-Davis K, McGavock H
Drug Utilization Research Unit, Queen's University of Belfast.
Br J Gen Pract. 1992 Jan;42(354):10-2.
The objective of this study was to assess whether practice size, as measured by the number of doctors, had any bearing on the range of drugs prescribed. All practices in the northern and western health boards in Northern Ireland were included in the study--a total of 132 practices (362 doctors) serving a population of 628,249. Prescribing data, obtained from the Department of Health and Social Services (Northern Ireland) information technology unit database, were analysed retrospectively for the month of January 1989. The number of different preparations prescribed in each of 22 therapeutic groups were counted. Hence a measure of the range of prescribing was assessed. A significant correlation was found between the number of different preparations prescribed and the number of general practitioners working in the practice. However, no correlation was found between the number of different drugs prescribed and the mean prescribing cost per patient or the mean list size of the doctors in each practice. The use of a practice prescribing policy was found to have no influence on the range of drugs prescribed, nor on the prescribing costs. The inference is that formal therapeutic policies may be difficult to implement within group practices. These results are of importance to general practitioners since the greater the number of different drugs prescribed the greater will be the risk of side effects and dangerous interactions.
本研究的目的是评估以医生数量衡量的诊所规模是否对所开药物的种类范围有任何影响。北爱尔兰北部和西部卫生委员会的所有诊所都纳入了该研究，共有132家诊所（362名医生），服务人口为628,249人。从卫生和社会服务部（北爱尔兰）信息技术部门数据库获取的处方数据，对1989年1月进行了回顾性分析。统计了22个治疗组中每组所开不同制剂的数量。因此评估了处方种类范围的一个指标。在所开不同制剂的数量与诊所中工作的全科医生数量之间发现了显著相关性。然而，在所开不同药物的数量与每位患者的平均处方费用或各诊所医生的平均在册患者数之间未发现相关性。发现采用诊所处方政策对所开药物的种类范围或处方费用均无影响。由此推断，正式的治疗政策可能难以在集体诊所中实施。这些结果对全科医生很重要，因为所开不同药物的数量越多，副作用和危险相互作用的风险就越大。
