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, Healthcare expenditure for dyspepsia could be better understood if the factors contributing to the expenditure for dyspepsia could be identified. Aims To determine whether prescribing costs of UHDs and use of endoscopy in general practice were related to the characteristics of the practices or to the characteristics of the population it served. Design Twenty-seven GP practices in south London were studied prospectively over 6 months. Prescribing costs for UHDs were obtained from PACT and data for endoscopies from hospital PAS systems. Demographic data on practice size, age and sex distribution were obtained from the district FHSA, The Jarman index, Townsend score and proportion of ethnic minorities in the practice population were determined from the Population Census Survey. Results Total expenditure on UHDs by the 27 practices was pound 1 million per annum and endoscopy rate was 1.1% per annum. Expenditure on UHDs was negatively correlated with practice size (P = 0.006) and use of open access endoscopy (P < 0.005) and positively correlated with number of patients aged over 45 years (P = 0.007). Endoscopy use 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 by both practice and population characteristics. (C) 1998 Lippincott-Raven Publishers.