Prescribing at the hospital-general practice interface. I: Hospital outpatient dispensing policies in England.
OBJECTIVE
To describe the outpatient dispensing policies of major acute hospitals in England.


METHODS
Postal questionnaire survey in November 1990.


METHODS
All (278) major acute hospitals in England with more than 250 beds, excluding maternity, paediatric, or psychiatric hospitals; nine hospitals declined.


METHODS
Hospital chief pharmacists.


METHODS
Current dispensing policy and exceptions to it; when the policy was formed; and who was involved in its formation.


RESULTS
Completed questionnaires were received from 200 (72%) of the hospitals approached. The quantities of drugs dispensed to outpatients ranged from zero in 12 hospitals to unlimited amounts in nine; nearly half (92) dispensed a 14 days' supply of drugs. The greater the restriction on outpatient dispensing, the more recently the policy had been introduced (chi 2 for trend = 7.15; df = 1; p less than 0.01). Permissible exceptions to the policy included the consultant's specific request (134 hospitals), difficulty in obtaining drugs in the community (102), urgent need for start of treatment (49), and certain types of patients (41) or drugs or their regimens (104). Groups who were neither represented on the hospital committee concerned with policy formation nor consulted before policy changes included regional health authorities in 122 hospitals, district health authorities in 101 hospitals, and general practitioners in 32 hospitals.


CONCLUSIONS
Outpatient dispensing policies varied considerably among the hospitals surveyed, but they seemed to be moving towards greater restrictions on the supply of drugs given to outpatients.
Wilkie
P
P
Department of General Practice and Primary Care, St George's Hospital Medical School, London.
Sibbald
B
B
Raftery
J
J
Anderson
S
S
Freeling
P
P
D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004739:England; D005194:Family Practice; D006801:Humans; D016134:Organizational Policy; D010045:Outpatients; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D013222:State Medicine; D011795:Surveys and Questionnaires