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Informing prescribing allocations at district level in England
N Rice1, R Carr-Hill, D Roberts
1Centre for Health Economics, University of York.
Journal of Health Services Research & Policy
|June 6, 1997
Summary
District prescribing costs in England are influenced by population health and socioeconomic factors. Morbidity indicators like permanent sickness and low birth weight, alongside general practitioner training, help predict cost variations.
Area of Science:
- Health economics
- Pharmaceutical policy
- Public health
Background:
- Prescribing costs vary significantly across English districts.
- Understanding factors influencing these costs is crucial for resource allocation.
- Previous models have not fully captured the interplay of demand and supply characteristics.
Purpose of the Study:
- To develop a predictive model for prescribing cost variations.
- To identify key demographic, socioeconomic, and morbidity factors influencing costs.
- To examine the relationship between general practice supply and prescribing costs.
Main Methods:
- Statistical analysis of 1994 cost data for 90 English districts.
- Exploration of inter-relations between morbidity, demographics, socioeconomic status, and prescribing costs (ASTRO-PU).
- Ordinary least squares regression to estimate associations and model predictive power.
Main Results:
- Three parsimonious models explained up to 61% of prescribing cost variation.
- Key predictors included permanent sickness, low birth weight, and proportion of GPs with postgraduate certificates.
- Weak relationship observed between measured supply factors; no reciprocal relationship found.
Conclusions:
- Both 'need' (morbidity) and 'supply' characteristics independently associate with prescribing cost variations.
- Permanent sickness and low birth weight serve as effective morbidity proxies for different population segments.
- Consideration of these morbidity indicators is recommended for future prescribing resource allocation.