Objectives: To compare the costs of prescribing for older people in nursing
homes with older people living at home and to compare patterns of prescrib
ing between these two groups.
Design: Retrospective case-control study.
Setting: Nine general practices in Nottinghamshire.
Subjects: Two hundred and seventy patients aged 65 years and over living in
nursing homes matched for age, sex and general practice, with 270 patients
living in their own homes.
Main outcome measures: A comparison of the costs of prescriptions, the numb
er of items on prescription and the types of drugs prescribed between the c
ases and controls.
Results: The mean cost of prescriptions per patient month was almost three
times higher for nursing home patients than controls (pound 45.27 compared
to pound 16.46). The mean number of items prescribed per patient month was
also higher in nursing home patients (5.60 compared to 2.55). Total costs o
f prescriptions for nursing home patients were higher than for controls (P
< 0.0001), as were total numbers of prescription items (P < 0.001). There w
ere differences in the types of medication prescribed between the two group
s, including considerably higher costs for central nervous system drugs, ul
cer healing drugs, laxatives and enteral nutrition in nursing home resident
s.
Conclusions: When calculating general practice prescribing budgets, nursing
home patients should have a greater weighting than other patients of simil
ar age and sex.