DETERMINANTS OF PRESCRIBING COSTS FOR ULCER-HEALING DRUGS AND UPPER GASTROINTESTINAL ENDOSCOPY IN GENERAL-PRACTICE

Background Prescriptions for ulcer-healing drugs (UHDs) and endoscopy costs represent major expenditures for dyspepsia in primary care, Heal thcare expenditure for dyspepsia could be better understood if the fac tors contributing to the expenditure for dyspepsia could be identified . Aims To determine whether prescribing costs of UHDs and use of endos copy in general practice were related to the characteristics of the pr actices or to the characteristics of the population it served. Design Twenty-seven GP practices in south London were studied prospectively o ver 6 months. Prescribing costs for UHDs were obtained from PACT and d ata for endoscopies from hospital PAS systems. Demographic data on pra ctice size, age and sex distribution were obtained from the district F HSA, The Jarman index, Townsend score and proportion of ethnic minorit ies in the practice population were determined from the Population Cen sus Survey. Results Total expenditure on UHDs by the 27 practices was pound 1 million per annum and endoscopy rate was 1.1% per annum. Expen diture on UHDs was negatively correlated with practice size (P = 0.006 ) and use of open access endoscopy (P < 0.005) and positively correlat ed with number of patients aged over 45 years (P = 0.007). Endoscopy u se was positively correlated with proportion of ethnic minorities (P = 0.008) and negatively with male:female ratio (P = 0.049). Conclusions Resource utilization on dyspepsia in general practice is determined b y both practice and population characteristics. (C) 1998 Lippincott-Ra ven Publishers.