ArticleBMJ (Clinical research ed.)1995
Alterations in prescribing by general practitioner fundholders: an observational study.
Article in BMJ (Clinical research ed.), 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmaceutical policies: effects of financial incentives for prescribers.The Cochrane database of systematic reviews · 2015Pooled it
- An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes.The Cochrane database of systematic reviews · 2011Pooled it
- The impact of physician-level drug budgets on prescribing behavior.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Article
- A prescription for improvement? An observational study to identify how general practices vary in their growth in prescribing costs.BMJ (Clinical research ed.) · 2000Article
- Therapeutic substitution and therapeutic conservatism as cost-containment strategies in primary care: a study of fundholders and non-fundholders.The British journal of general practice : the journal of the Royal College of General Practitioners · 1999Article
- A comparison of three methods of setting prescribing budgets, using data derived from defined daily dose analyses of historic patterns of use.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Article
- Health care expenditures after introduction of a gatekeeper and a global budget in a Swiss health insurance plan.Journal of epidemiology and community health · 1998Article
- General practice fundholding: progress to date.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Review
- Strategies to improve the cost effectiveness of general practitioner prescribing. An international perspective.PharmacoEconomics · 1997Review
- Drug rationing in the UK National Health Service. Current status and future prospects.PharmacoEconomics · 1997Review
- Poles apart? The views of general practitioners and family health services authority advisers on prescribing cost issues.The British journal of general practice : the journal of the Royal College of General Practitioners · 1997Article
- Fundholders' prescribing costs: the first five years.BMJ (Clinical research ed.) · 1996Article
- Influences of practice characteristics on prescribing in fundholding and non-fundholding general practices: an observational study.BMJ (Clinical research ed.) · 1996Article
- A prescribing incentive scheme for non-fundholding general practices: an observational study.BMJ (Clinical research ed.) · 1996Article
- Effects of fundholding on prescribing habits. Results of similar study in Mersey were different.BMJ (Clinical research ed.) · 1996Article
- Prescribing by general practitioner fundholders. Other factors probably explain differences in prescribing.BMJ (Clinical research ed.) · 1996Article
- Prescribing by general practitioner fundholders. Longer study shows that costs rise again after initial savings.BMJ (Clinical research ed.) · 1996Article
- General practitioners' views on over the counter sales by community pharmacists.BMJ (Clinical research ed.) · 1996Article
- The UK pharmaceutical market. An overview.PharmacoEconomics · 1996Article
- Buccaling under the pressure: influence of secondary care establishments on the prescribing of glyceryl trinitrate buccal tablets in primary care.BMJ (Clinical research ed.)Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare prescribing in general practices before and after they become fundholders to assess whether this affected prescribing patterns.
designAnalysis of prescribing data (PACT) for one year before and one year after practices become first, second, or third wave fundholders and comparison with practices that were not fundholders during any part of the study.
main outcome measuresPrescribing costs (net ingredient cost per prescribing unit), prescribing volume (items per 1000 prescribing units), net ingredient cost per item, and percentage of generic prescribing.
settingFormer Mersey Regional Health Authority. SUBJECTS: 100 fundholders (20 first wave, 31 second wave, 49 third wave) and 312 nonfundholders.
resultsPrescribing costs and volume rose throughout the study in all groups. In all three fundholding waves the rate of increase of prescribing costs was significantly lower than for nonfundholders. Both cost per item and prescribing volume tended to decrease, the former probably because of a significant increase in generic prescribing. Fundholding and non-fundholding practices differed in several respects.
conclusionFundholding has altered practice prescribing patterns compared with those of nonfundholders, increasing generic prescribing and reducing the rate of increase of prescribing costs.
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