Reduction in prescribing cannot confidently be attributed to scheme

BMJ 1996;313:1484 (7 December)

Letters

Reduction in prescribing cannot confidently be attributed to scheme

EDITOR,--D N Bateman and colleagues set out to examine the effectsof a financial incentive scheme on prescribing among non-fundholdinggeneral practitioners. We are not convinced, however, that theyhave shown that these general practitioners responded to suchincentives in a manner similar to that of fundholding practices,as the authors claim.

Firstly, from a purely descriptive viewpoint, the proportionof practices achieving the target reduction was relatively modest(23% of all practices). More importantly, however, there areno control data either from practices outside the scheme orin the form of historical trend data from the practices in thescheme. As the authors acknowledge in their discussion--butignore in their abstract--this means that causal attributionof the reduction in prescribing to the incentive scheme is notpossible with confidence. Other, secular, trends may have beenresponsible. Correcting this important deficit is a questionnot merely of undertaking further analysis, . . . [Full text of this article]

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Relevant Article

A prescribing incentive scheme for non-fundholding general practices: an observational study: D N Bateman, M Campbell, L J Donaldson, S J Roberts, and J M Smith
BMJ 1996 313: 535-538. [Abstract] [Full Text]