Drug prescribing in hospital as experienced by general practitioners: East versus West Germany.
OBJECTIVE
Drugs prescribed by the general practitioner (GP) are often changed during hospitalization. This study set out to test the hypothesis that the extent of drug change and the information provided by the hospital determines the GPs' assessment of hospital co-operation. The perception of drug change and hospital co-operation may also be influenced by the degree of institutional separation of primary and secondary care. Therefore we compared GPs' respective attitudes in 'East' and 'West' Germany.


METHODS
In 1993, a representative sample of 'eastern' and 'western' German doctors received a structured questionnaire; 554 doctors (63%) participated.


RESULTS
Fifty-seven per cent of the western and 39% of the eastern GPs believed that their medication was changed in hospital in more than 60% of their patients. Only a minority of eastern (10%) and western (15%) doctors described the information provided by the hospitals as more or less satisfactory. More western than eastern doctors (56% versus 32%) expressed dissatisfaction with hospital co-operation. Respondents in eastern Germany who felt sufficiently informed about hospital drug change were more likely to express satisfaction with the hospital doctors' co-operation. In the former area of West Germany the judgement of co-operation was significantly better if the extent of drug change and the frequency of generic drug replacement by original brand-name drugs were lower.


CONCLUSIONS
The study showed that hospital-initiated drug change is a matter of concern, especially for GPs who are working in an area with a tradition of strictly separated primary and secondary care.
Himmel
W
W
Department of General Practice, University of Goettingen, Germany.
Kron
M
M
Hepe
S
S
Kochen
M M
MM
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D011307:Drug Prescriptions; D004363:Drug Utilization; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D005858:Germany; D018578:Hospital-Physician Relations; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires