DRUG PRESCRIBING IN-HOSPITAL AS EXPERIENCED BY GENERAL-PRACTITIONERS - EAST VERSUS WEST-GERMANY

Background and objectives. Drugs prescribed by the general practitione r (GP) are often changed during hospitalization. This study set out to test the hypothesis that the extent of drug change and the informatio n provided by the hospital determines the GPs' assessment of hospital co-operation. The perception of drug change and hospital co-operation may also be influenced by the degree of institutional separation of pr imary and secondary care. Therefore we compared GPs' respective attitu des in 'East' and 'West' Germany. Method. In 1993, a representative sa mple of 'eastern' and 'western' German doctors received a structured q uestionnaire; 554 doctors (63%) participated. Results. Fifty-seven per cent of the western and 39% of the eastern GPs believed that their me dication was changed in hospital in more than 60% of their patients. O nly a minority of eastern (10%) and western (15%) doctors described th e information provided by the hospitals as more or less satisfactory. More western than eastern doctors (56% versus 32%) expressed dissatisf action with hospital co-operation. Respondents in eastern Germany who felt sufficiently informed about hospital drug change were more likely to express satisfaction with the hospital doctors' co-operation. In t he former area of West Germany the judgement of co-operation was signi ficantly better if the extent of drug change and the frequency of gene ric drug replacement by original brand-name drugs were lower. Conclusi ons. The study showed that hospital-initiated drug change is a matter of concern, especially for GPs who are working in an area with a tradi tion of strictly separated primary and secondary care.