Does secondary care impact on primary care prescribing performance?

摘要

Aim To examine the influence of hospital prescribing activity on primary care prescribing activity for statins and for angiotensin-converting enzyme inhibitors and angiotensin-2 receptor antagonists. Design Data were sourced from IMS Health's dataset. Results The combined use of simvastatin and pravastatin as a percentage of all statin use across 17 West Midlands primary care trusts was 74.2%. The figure for 17 West Midlands hospitals was 75.6%. The difference was not statistically significant (P=0.385). The combined ACE inhibitor use as a percentage of all ACE and ARB prescribing across the 17 PCTs was71.7%Thefigureforthe 17 hospitals was 79.0%, The difference was statistically significant (P<0.001), however linear regression analysis of paired PCT/hospital data for six groups where more than 80% of a hospital's contract activity was with its host PCT showed no correlation between hospital and PCT use of angiotensin inhibitors (R~2=0.128). Conclusion Hospital prescribing is not adversely influencing primary care prescribing in the West Midlands in the context of the "Better care, better value" indicators.