University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Postgrad Med J. 2013 Jun;89(1052):316-22. doi: 10.1136/postgradmedj-2012-131334. Epub 2013 Mar 20.
To investigate the variation in the net ingredient cost (NIC) of the medications most commonly prescribed by Foundation Year 1 (F1) doctors in a teaching hospital and to compare the effects of working in different specialties and rotations on this cost.
Retrospective review of prescription data from 5 August 2010 to 3 August 2011 extracted from an electronic prescribing system.
The F1 doctors generated 81 316 prescriptions with an estimated total cost of £579 398. The mean NIC per doctor was £7334 (SE=£430). Prescribing costs varied significantly across clinical departments and between drug classes considered in the analysis. Specifically, prescribing in the infection and respiratory drug categories and within the trauma and orthopaedics department was associated with higher prescribing costs. Significant variability was also attributable to the prescribing doctor (p<0.001) with average prescription costs ranging from 72.2% lower to 193.8% higher than the median doctor.
There is considerable variation in the total costs of medications prescribed by F1 doctors, even after considering a range of prescription factors. This variation may suggest that some doctors are prescribing uneconomically relative to the rest of the cohort. Knowledge of which clinical areas and drug classes have higher NICs may allow an alternative focus for medicine management teams and postgraduate education.
调查在教学医院中，由一年级住院医师（F1）最常开处方的药物的净成分成本（NIC）的变化，并比较在不同专业和轮班工作对这一成本的影响。
回顾性审查 2010 年 8 月 5 日至 2011 年 8 月 3 日从电子处方系统中提取的处方数据。
F1 医生共开出 81316 张处方，估计总费用为 579398 英镑。每位医生的平均 NIC 为 7334 英镑（SE=£430）。处方费用在临床科室之间和分析中考虑的药物类别之间存在显著差异。具体来说，感染和呼吸系统药物类别的处方以及创伤和矫形科的处方与更高的处方费用相关。处方医生之间也存在显著的可变性（p<0.001），平均处方费用比中位数医生低 72.2%至高 193.8%。
即使考虑了一系列处方因素，F1 医生开处方的药物总成本仍存在相当大的差异。这种差异可能表明，与其他医生相比，一些医生的处方不经济。了解哪些临床科室和药物类别具有更高的 NIC，可以使药物管理团队和研究生教育有针对性地关注其他领域。
