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Biomedical subjects

G Scrivener

Publications and source records attributed to G Scrivener.

7 recordsLinked to original sources
PubMed1997

The changing relationship between prescribing and unemployment at family health service authority level in England, 1983-92.

STUDY OBJECTIVE: To investigate the relationship between unemployment and prescribing costs over time. DESIGN: This was a longitudinal study. SETTING: All 90 family health service authorities in England, 1983-92. PARTICIPANTS: All general practices in England. MAIN RESULTS: The strength of the relationship varied over the period, falling to a very low value during the last two years of the decade. CONCLUSION: Unemployment rates are not suitable as a proxy for the determination of prescribing costs.

Adolescent↗
PubMed1996

Fundholders' prescribing costs: the first five years.

OBJECTIVES: To determine whether the first five waves of English fundholding practices have reduced their prescribing costs relative to non-fundholding practices, and the duration of any reduction achieved. DESIGN: Analysis of item and cost data for all general practices in England in the six years from April 1990 to March 1996. The practices of each of the first five waves were identified at the Prescription Pricing Authority. SETTING: All general practices in England. MAIN OUTCOME MEASURES: Changes and rates of change in net ingredient cost per prescribing unit, and changes in number of items per prescribing unit in fundholding practices, before and after fundholding, relative to continuing non-fundholders. RESULTS: Absolute prescribing costs increased over the six years, by 66% in the continuing non-fundholders and by 56-59% for fundholders. Successive waves of fundholders showed a similar pattern of change: a small relative reduction in the pre-fundholding year, maximum relative reduction in the first year, and a declining relative reduction in the second and third years. After this, their increases in costs were largely similar to those of non-fundholders. The number of items dispensed remained stable over the six years in all groups. CONCLUSIONS: The real budgets operated by fundholders were associated with a reduction in costs of about 6% relative to continuing non-fundholders, and this saving seemed to be retained during the study. The relative reduction was small compared with the absolute increase seen in all groups and disappeared after the third year of fundholding. It was brought about by lowering the average cost per item rather than by giving fewer items.

Budgets↗
PubMed1995

Allocating census data to general practice populations: implications for study of prescribing variation at practice level.

OBJECTIVES: To assign census data to general practice populations and to test accuracy of different procedures for estimating the proportion of patients aged over 64. DESIGN: Patients' postcodes from patient register of one family health services authority and the directory linking postcodes to census enumeration districts were used to locate patients in their census area of residence. With different levels of census geography and four different allocation procedures, proportion of patients aged over 64 in each area was used to predict proportion of patients aged over 64 in each general practice. Predicted figures were compared with real figures from each practice register to assess accuracy of allocation methods. SETTING: Data from 1991 census and from 73 practices administered by one family health services authority. MAIN OUTCOME MEASURES: Actual and predicted proportions of patients aged over 64 in general practice populations. RESULTS: Correlations between actual and predicted proportions of patients aged over 64 were significant for all four allocation procedures--values of 0.66, 0.7, 0.84, and 0.84 were achieved (P < 0.0005). Predicted ranges of proportions of patients aged over 64, however, were well short of those that actually existed, and significant differences existed between predicted percentages and actual figures for all four methods. CONCLUSION: Although predicted values correlated with actual values, the failure of the allocation procedures to correctly predict values, especially at the extremes, casts doubt on the validity of similar techniques for allocating census variables to general practice populations.

Age Factors↗