title: Do GPs working in practice with high or low prescribing costs have different views on prescribing cost issues?
abstract: BACKGROUND
  In a previous study we found that a minority of general practitioners (GPs) had different views to health authority advisers on a number of prescribing cost issues. However, there were few differences between subgroups of GPs. We hypothesised that subgroups that might show differences were GPs from practices with either high or low prescribing costs.
  
  
  OBJECTIVE
  To assess differences in views on prescribing cost issues between GPs working in practices with either high or low prescribing costs.
  
  
  METHODS
  Using PACTLINE data, prescribing costs were obtained for general practices within the Trent Region for the financial year 1996 to 1997. A questionnaire was sent anonymously to 340 GPs working in those practices with high prescribing costs, and to 322 GPs working in practices with the lowest prescribing costs.
  
  
  RESULTS
  A total of 216 (63.5%) GPs from high-cost practices and 194 (60.2%) from low-cost practices responded. There were statistically significant differences between the two groups on seven out of 22 statements. However, when the confounding effect of fundholding was taken into account, significant differences were found for just three statements and each of these related to substitution with comparable but cheaper drugs.
  
  
  CONCLUSIONS
  GPs working in practices with either high or low prescribing costs had different views on a number of statements concerning substitution with comparable but cheaper drugs. When encouraging GPs to control their prescribing costs, a different approach may be required for doctors in some high-cost practices.
authors.affiliation: Division of General Practice, Trent Institute for Health Services Research, School of Community Health Sciences, University Hospital, Nottingham. Tony.Avery@nottingham.ac.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Avery
authors.forename: R V
authors.initials: RV
authors.lastname: Wetzels
authors.forename: S
authors.initials: S
authors.lastname: Rodgers
authors.forename: C
authors.initials: C
authors.lastname: O'Neill
mesh_terms: D001291:Attitude of Health Personnel; D016527:Drug Costs / Q000706:statistics & numerical data*; D005194:Family Practice / Q000191:economics*; D019538:Health Care Surveys; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires