The association of some practice characteristics with antibiotic prescribing

Background: Antibiotic prescribing in general practice is often considered inappropriate, and its volume excessive. Considerable variation in antibiotic prescribing volume and costs exists among practices.

Objective: To investigate some factors behind the variation in antibiotic prescribing among general practices, by examining the contribution to this variation of the level of deprivation in the practice population, training status, partnership status, and fundholding status.

Method: Analysis of prescribing data (PACT) from 351 practices in the Mersey region for the year ending March 1991 and the year ending March 1994; prescribing data standardized for variation in practice population demography. Use of multiple linear regressions to investigate the variation among practices in standardized prescribing volume and standardized prescribing costs, in both years.

Results: Level of deprivation, training status and partnership status contributed to the models explaining variation in prescribing volume. The same variables contributed to the model explaining variation in prescribing costs in the year ending March 1991. For the year ending March 1994, level of deprivation, training status, and fundholding status contributed to all models.

Conclusion: Higher levels of antibiotic prescribing occur in practices serving more deprived communities, in single-handed practices, and in non-training practices. These higher levels of prescribing may be due to higher levels of morbidity, but may also reflect the organization and attitudes of these practices.