THE USE OF THE ASTRO-PU AND THE ASTRO(97)-PU IN THE SETTING OF PRESCRIBING BUDGETS IN ENGLISH GENERAL-PRACTICE

Objectives: To examine the variation in prescribing costs explained by the Age, Sex and Temporary Resident Originated Prescribing Unit (ASTR O-PU) and its replacement, the ASTRO (97)-PU, in order to determine th e appropriateness of their use in the setting of prescribing budgets i n English general practice. Methods: Linear regression analysis was us ed to analyse routinely collected patient and prescribing data from on e English health authority (Lincolnshire Health) for the fiscal year 1 995. Results: The goodness-of-fit of the regression models constructed varied according to whether practices had dispensing status (i.e. rur al practices that have permission to dispense drugs to their own patie nts as a means of compensating for the lack of pharmacies in such area s), with the ASTRO-PU and ASTROP(97)-PU explaining a higher proportion of the variation in prescribing costs amongst practices with such sta tus. Conclusions: This paper draws two main conclusions. First, the we ights embodied in the ASTRO-PU and the ASTRO(97)-PU may have been bias ed by the number of dispensing practices sampled during their construc tion. Second, the denominators may be more applicable to dispensing pr actices, implying that primary care groups may need to follow the prin ciple of 'local flexibility' during the budget-setting process.