Healey A T, Yule B F, Reid J P
Health Economics Research Unit, University of Aberdeen, Scotland.
Health Econ. 1994 Jan-Feb;3(1):47-56. doi: 10.1002/hec.4730030107.
Indicative prescribing amounts, and the equivalent prescribing element of funds in the case of fund-holding practices, are now an established part of UK general practice. This paper examines the implications of variations in GP prescribing behaviour for the determination of prescribing budgets. Using regression analysis, the extent to which variations in total practice prescribing costs can be explained by factors suggested for inclusion in a weighted capitation formula is established. The results indicate that 97% of the variation in practice prescribing costs can be explained by differences in practice list size, the proportion of patients aged 65 years and over, the proportion of patients living in 'deprived areas' and whether or not the practice qualifies for 'inducement payments'. The implications of the results for budget setting are discussed. A resource allocation formula based on regression analysis of expenditures can be used to promote horizontal equity in terms of equal budgets for equal need. However, its implications for vertical equity and efficiency are more ambiguous.
指示性处方量以及在实行基金持有制情况下资金的等效处方要素，如今已成为英国全科医疗的既定组成部分。本文探讨了全科医生处方行为的差异对处方预算确定的影响。通过回归分析，确定了实践中总处方成本的差异可由建议纳入加权人头费公式的因素解释的程度。结果表明，实践处方成本97%的差异可由实践名单规模的差异、65岁及以上患者的比例、生活在“贫困地区”的患者比例以及该实践是否符合“诱导性支付”条件来解释。讨论了这些结果对预算设定的影响。基于支出回归分析的资源分配公式可用于在同等需求下实现平等预算，从而促进横向公平。然而，其对纵向公平和效率的影响则更为模糊。
