FAMILY PRACTITIONERS INTERVENTION AGAINST SMOKING IN GERMANY AND THE UK - DOES REMUNERATION AFFECT PREVENTIVE ACTIVITY

The effect of different systems of remuneration on preventive activity of family practitioners (FPs) were studied. Interventions against smo king were compared in FPs' practices in Germany and the UK. Almost 800 consecutively attending patients were included in a cross-sectional s urvey. Smoking prevalence was remarkably similar among German and Brit ish practice attenders. Slightly more than 50% of smokers in both coun tries remembered an intervention against their smoking by their FP or related staff. Multiple logistic regression analysis also showed that there was no significant difference for remembered interventions betwe en the two countries (adjusted OR 1.15 [95%-Cl 0.6, 2,2]). The structu re of interventions employed was similar in both countries. Most Briti sh and German ex-smokers denied that their FP had made an important co ntribution to their giving up smoking. There is evidence that, under c apitation, FPs concentrate their activities on patients who are more a t risk. Overall, however, the economic structure does not seem to infl uence the core of preventative behaviour of FPs to any great extent. S moking cessation efforts in Family Practice need to be improved in bot h countries.