PMID: 7939853Aug 1, 1994Paper

Accounting for medical variation: the case of prescribing activity in a New Zealand general practice sample

Social Science & Medicine
P B DavisJ Millar

Abstract

Medical practice variation is extensive and well documented, particularly for surgical interventions, and raises important questions for health policy. To date, however, little work has been carried out on interpractitioner variation in prescribing activity in the primary care setting. An analytical model of medical variation is derived from the literature and relevant indicators are identified from a study of New Zealand general practice. The data are based on nearly 9,500 completed patient encounter records drawn from over a hundred practitioners in the Waikato region of the North Island, New Zealand. The data set represents a 1% sample of all weekday general practice office encounters in the Hamilton Health District recorded over a 12-month period. Overall levels of prescribing, and the distribution of drug mentions across diagnostic groupings, are broadly comparable to results drawn from international benchmark data. A multivariate analysis is carried out on seven measures of activity in the areas of prescribing volume, script detail, and therapeutic choice. The analysis indicates that patient, practitioner and practice attributes exert little systematic influence on the prescribing task. The principal influences are diagno...Continue Reading

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Citations

Jan 1, 1995·International Journal of Technology Assessment in Health Care·P Davis, B Gribben
Jul 27, 2011·Family Practice·Liset van DijkDinny H de Bakker
Jul 4, 1998·Journal of Vascular Surgery·D J WirthlinW M Abbott
Aug 26, 2003·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Richard R OwenBrenda M Booth
Aug 4, 2009·Pharmacy World & Science : PWS·J G HugtenburgJ J Beckeringh
Sep 5, 1994·PharmacoEconomics·R J Milne
Oct 1, 2010·Public Opinion Quarterly·Adeline Delavande, Charles F Manski
Nov 21, 2018·BMC Medical Informatics and Decision Making·Alexander RosenbergMartin S Zand

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