Monitoring the variability in drug-prescribing patterns: benchmarking and feedback in Belgium

Health-care providers, insurance agencies, ministries, clinicians etc. are installing Information and Communication Technology to monitor patients, patient care and pharmaceutical drug-prescribing patterns. The ever-growing databases create opportunities for better knowledge about the health-care system and, eventually, more effective management. Yet, these databases run the risk of under-utilisation or simplistic interpretation through lack of appropriate knowledge methodology. On the one hand, managers and policy makers oversimplify the available information. Numerous individual patients and pharmaceutical drugs are classified into a small number of categories and measured using Great British pounds or Euros. Sums, averages and two-way tables cover up all the fine shades in patient problems and therapies that are recorded in great detail. On the other hand, investigations discover a wide diversity of patients and a great variability of care patterns among clinicians, hospitals and regions. When so-called unexplained regional, institutional and clinician differences are published, confusion and distrust arise. Examples exist in France, the USA, the UK and Belgium. This document investigates how to discover management knowledge with respect to drug prescribing patterns. The example presented covers the cases of the 18,000 Belgian home practitioners.