Somerville College, University of Oxford, Oxford, UK
School of Mathematics and Physics, Queen's University Belfast, Belfast, UK.
Fam Med Community Health. 2020 Jun;8(3). doi: 10.1136/fmch-2020-000376.
In the present study, we sought to explore the relationship between socioeconomic status and prescribing magnitude and cost in primary care throughout Northern Ireland.
We performed a retrospective data analysis of general practitioner (GP) prescribing using open-source databases with data collected from May to October 2019 to determine the number of prescriptions and cost of drugs and drug classes by area, ranking these by deprivation index. We used Kendall's tau to quantify the relationship between prescribing and deprivation.
We analysed open-source data collected from 325 GP practices in Northern Ireland during the period from May to October 2019.
We analysed a total of 2 764 303 prescriptions signed during our study period.
Our study indicates a clear trend of increased overall spending per patient (r=-0.1232, p=0.02) and number of prescriptions per patient (r=-0.3440, p<0.001) in areas of higher deprivation. The mean cost per item was higher in less deprived areas (r=0.3809, p<0.001). Overall, £13.79 more was spent and 3.5 more items were prescribed per patient in the most compared with the least deprived decile, although more expensive items tended to be prescribed in areas with lower socioeconomic deprivation (£11.27 per item vs £9.20 per item). We found a statistically significant correlation of prescribing of key drug classes, such as bronchodilators, antidepressants and drugs used to treat diabetes, among others, with greater deprivation. Prescribing of vaccines and drugs used in the treatment of glaucoma was correlated with lower deprivation.
We provide an exploration of the correlation of prescribing with deprivation by analysing all prescriptions signed within a 6-month period in Northern Ireland. Our study broadly agrees with published literature, although a few notable exceptions are highlighted. We provide evidence of discrepancies in medication cost between areas of differing deprivation and suggest possible explanations for these trends. This information will be valuable for future investigation of disease prevalence, as well as targeting of patient education and future funding.
本研究旨在探讨北爱尔兰初级保健中社会经济地位与处方数量和费用之间的关系。
我们使用开源数据库对全科医生（GP）的处方进行回顾性数据分析，数据采集时间为 2019 年 5 月至 10 月，以确定按地区划分的处方数量和药物及药物类别费用，并按贫困指数对其进行排名。我们使用 Kendall's tau 量化了处方与贫困之间的关系。
我们分析了 2019 年 5 月至 10 月期间北爱尔兰 325 家全科医生诊所的开源数据。
我们分析了研究期间共 2764303 张处方。
我们的研究表明，在贫困程度较高的地区，每位患者的总支出（r=-0.1232，p=0.02）和每位患者的处方数量（r=-0.3440，p<0.001）呈明显上升趋势。较贫困地区的单位成本更高（r=0.3809，p<0.001）。与最贫困的十分位数相比，最贫困和最富裕地区的每位患者分别多支出 13.79 英镑，多开 3.5 种药物，但较低社会经济贫困地区的处方更昂贵（每单位 11.27 英镑，而每单位 9.20 英镑）。我们发现，一些关键药物类别的处方，如支气管扩张剂、抗抑郁药和治疗糖尿病的药物等，与贫困程度呈显著相关。疫苗和治疗青光眼的药物的处方与贫困程度呈负相关。
我们通过分析北爱尔兰 6 个月内所有签名处方，探讨了处方与贫困之间的相关性。我们的研究与已发表的文献基本一致，但也有一些值得注意的例外。我们提供了不同贫困程度地区药物费用差异的证据，并对这些趋势提出了可能的解释。这些信息对于未来疾病流行率的研究以及患者教育和未来资金的目标定位将具有重要价值。
