Alterations in prescribing by general practitioner fundholders: an observational study

Wilson, Robert; Buchan, Iain; Walley, Tom

doi:10.1136/bmj.311.7016.1347

Cited by 58 publications

(39 citation statements)

References 10 publications

(9 reference statements)

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“…In accordance with research into changes made by general medical practitioners, [24][25][26] this study assessed change within general dental practice based upon self reports. Such an approach has some limitations.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and nature of recent self-reported changes in general dental practice in a sample of English general dental practitioners

et al. 2004

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Objective To determine the extent and types of change in seven domains of dental practice in a sample of English general dental practitioners (GDPs). Methods A postal questionnaire was sent to 561 GDPs on the dental lists of three health authorities in diverse regions of England. Information collected included demographic details on personal and practice characteristics, self-rating of amount of change in the seven domains of practice and factors influencing change. Results The response rate was 60%. Fifty-six per cent of the sample were under 40 years old. Over a third of respondents reported 'changing a lot or completely' certain clinical activities, practice management arrangements and practice amenities. The highest selfreported level of change was in clinical activities. Of the GDPs who reported changing their clinical activities, 56% reported an increase in preventive care, followed by crown and bridge (44%), periodontics (44%) and endodontics (43%). Practice management rated second in the mean rank scores for self-reported change. The main changes reported were the introduction of computer systems and employment of practice managers. A sizeable percentage (66%) reported increasing the amount of information they provided to patients and the time spent discussing care. Quality assurance activities were the area of practice least likely to have changed over a 5-year period. Over half the sample reported not being involved in any quality assurance activities in the previous 5 years. Those respondents who were younger, had a postgraduate qualification and earned more than 20% of their income from private practice reported higher levels of change. Conclusions General dental practitioners' work patterns are dynamic and appear to be responding to changing needs and demands on their

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Section: Discussionmentioning

confidence: 99%

The prevalence and nature of recent self-reported changes in general dental practice in a sample of English general dental practitioners

et al. 2004

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“…It is, however, difficult to argue conclusively that overall efficiencies in prescribing have resulted, as many practices strategically delayed entry into the fundholding scheme to maximise their prescribing budgets (Wilson, Buchnan & Walley 1995).…”

Section: Flow-on Costsmentioning

confidence: 99%

“…Budget-holding introduces incentives to encourage cost-effective care through making GPs, as purchasers, responsible for the wider flow-on costs of any care prescribed and providing an effective cap on the level of overall public expenditure (Malcolm & Powell 1996). For pharmaceuticals, this means that GPs will more carefully consider which drug is most appropriate and in which circumstance and, thus, prescribing of the most expensive 'flavour of the month' drug is unlikely to be sustained (Wilson, Buchnan & Walley 1995).…”

Section: Flow-on Costsmentioning

confidence: 99%

Budget-holding: The answer to Australian primary care reform?

Wilton¹,

Smith²

1999

Aust. Health Review

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“…183,184 Evaluations of the impact of fundholding on prescribing have also used PPA data. [185][186][187][188] The Health Survey for England (HSE) differs from other databases discussed here in being a regular survey of some 20,000 individuals by household. It has been used to show the proportions of people with raised cholesterol who are taking lipidlowering medication.…”

Section: Use In Ht Assessmentmentioning

confidence: 99%

Potential use of routine databases in health technology assessment

Raftery

Roderick²,

Stevens³

2005

Health Technol Assess

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Alterations in prescribing by general practitioner fundholders: an observational study

Cited by 58 publications

References 10 publications

The prevalence and nature of recent self-reported changes in general dental practice in a sample of English general dental practitioners

The prevalence and nature of recent self-reported changes in general dental practice in a sample of English general dental practitioners

Budget-holding: The answer to Australian primary care reform?

Potential use of routine databases in health technology assessment

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