[Prescription of drugs in family medicine: on the trail of efficiency].
OBJECTIVE
To analyse the effect of various factors on the efficiency of drug prescription by general practitioners (GPs).


METHODS
Descriptive, cross-sectional study.


METHODS
Primary care in Murcia, Cartagena, and Lorca, in which 535 GPs work in the care of 921,281 people. Murcia Region (Spain).Participants. Prescriptions issued by the 288 GPs who were working constantly and continuously in May-June 1998 and who were away from work for no longer than 10% of the time (53.8%).


METHODS
We measured their efficiency with two general indicators--potential saving (PS) and prescription of generics (PG)--and 3 specific indicators: efficiency of prescription of omeprazole (EO), enalapril (EE), and ranitidine (ER). We analysed their relationship with structural-organisational factors and with the population attended, the doctor and his/her action. Bivariate and multivariate analyses (logistic regression) were used.


RESULTS
There was an association with programmed consultation (PC); a weak inverse relationship with age of doctor, years qualified, pensioners allocated, case load and inter-consultations conducted; and a direct correlation with the length of the consultation. PG was related to rural environment, being non-permanent, specialist in family medicine, belonging to a primary care team. In the multivariate analysis PC was related to all the indicators: PS (OR=1.96), PG (OR=2.10), EO (OR=2.63), ER (OR=2.84), EE (OR=2.06); and the inter-consultations conducted with general efficiency of PS (OR=1.70), PG (OR=1.91). Rural environment was the worst for PS (OR=2.43).


CONCLUSIONS
The main factors related to the efficiency of GPs prescription can be changed. The most important is the existence of PC. A lot of inter-consultations and working in a rural environment means worse general efficiency.
López-Picazo Ferrer
J J
JJ
Unidad de Calidad, Gerencia de Atención Primaria de Murcia, Murcia, Spain. julioj.lopez-picazo@carm.es
Sánchez Ruiz
J F
JF
Rausell Rausell
V
V
Sanz Moreno
J A
JA
Sánchez Rodríguez
F
F
Salas Martín
E
E
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data; D005194:Family Practice / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*
Prescripción de medicamentos en medicina de familia: tras las pistas de la eficiencia.