Lloyd D C, Harris C M, Roberts D J
Prescribing Research Unit, University of Leeds, Research School of Medicine.
BMJ. 1995 Oct 14;311(7011):991-4. doi: 10.1136/bmj.311.7011.991.
To derive cost comparators for prescribing by English general practitioners in eight specific therapeutic groups, based on age-sex related weightings, and to confirm, from a new dataset, earlier age-sex weightings for overall prescribing (ASTRO-PUs).
Calculations based on one year's prescribing data from selected practices using AAH Meditel software, held on MediPlus by Intercontinental Medical Statistics (IMS, UK and Ireland), and research practices using VAMP software, held on the General Practice Research Database.
112 English practices with 739,672 patients and 510 British practices with 3,126,570 patients.
Cost based weightings for 18 age-sex groups and for temporary residents for eight leading specific therapeutic groups and for prescribing overall.
The two datasets were similar in age distribution and in the way that prescription numbers were distributed by age-sex band in each therapeutic group. The cost based weightings for specific therapeutic groups showed great variation in the use of these groups for patients in different age-sex groups. When these weightings were applied to the prescribing of practices in two family health services authorities they differed in their power to predict prescribing costs: for cardiovascular and gastrointestinal drugs predictive power was particularly high; for drugs for infections it was particularly low, since these are widely used at all ages and for both sexes. Cost based weightings for overall prescribing derived from the IMS data were similar to those of the ASTRO-PU system even though they were derived by different methods from different datasets.
The weightings (STAR-PUs) offer a sound basis for cost comparisons at the therapeutic group level. Cost-based weightings for overall prescribing derived from the IMS data were reassuringly similar to those of the existing ASTRO-PU system.
基于年龄 - 性别相关权重,得出英国全科医生在八个特定治疗组中的处方成本比较指标,并从一个新数据集中确认早期用于总体处方的年龄 - 性别权重(ASTRO - PUs)。
使用洲际医学统计公司(英国和爱尔兰的IMS)在MediPlus上保存的AAH Meditel软件,对选定诊所的一年处方数据进行计算,以及使用在全科医学研究数据库上保存的VAMP软件,对研究诊所的数据进行计算。
112家英国诊所,共739,672名患者;510家英国诊所,共3,126,570名患者。
18个年龄 - 性别组以及临时居民在八个主要特定治疗组和总体处方方面基于成本的权重。
两个数据集在年龄分布以及每个治疗组中按年龄 - 性别组分布的处方数量方式上相似。特定治疗组基于成本的权重显示,不同年龄 - 性别组的患者在使用这些治疗组方面存在很大差异。当将这些权重应用于两个家庭健康服务机构的诊所处方时,它们预测处方成本的能力有所不同:对于心血管和胃肠道药物,预测能力特别高;对于感染性疾病药物,预测能力特别低,因为这些药物在所有年龄段和两性中都广泛使用。即使从不同数据集通过不同方法得出,从IMS数据得出的总体处方基于成本的权重与ASTRO - PU系统的权重相似。
这些权重(STAR - PUs)为治疗组层面的成本比较提供了可靠依据。从IMS数据得出的总体处方基于成本的权重与现有ASTRO - PU系统的权重相似,令人放心。