Understanding the effects of a decentralized budget on physicians' compliance with guidelines for statin prescription – a multilevel methodological approach
2007

Effects of a Decentralized Budget on Statin Prescription Guidelines

Sample size: 182839 publication Evidence: moderate

Author Information

Author(s): Henrik Ohlsson, Juan Merlo

Primary Institution: Lund University, Sweden

Hypothesis

A decentralized pharmacologic budget would result in increased use of recommended statins and decreased variance between health care centers.

Conclusion

A decentralized drug budget seems to promote adherence to guidelines for statin prescription, but high practice differences suggest further improvements are needed.

Supporting Evidence

  • Adherence to guidelines increased continuously after the decentralized budget was implemented.
  • Prescription of recommended statins showed high clustering within both public and private health care centers.
  • Overall, guideline adherence was 62% in the public sector and 50% in the private sector.

Takeaway

When doctors have more control over their budgets, they tend to follow guidelines better when prescribing statins, but there are still big differences in how well they do this.

Methodology

Multilevel regression analyses on prescriptions issued at public and private health care centers over a 25-month period.

Potential Biases

Selection biases may affect the interpretation of the information campaign's impact on adherence.

Limitations

The study is observational, which may introduce bias and confounding factors.

Participant Demographics

The mean age of patients was 67 years for public prescriptions and 66 years for private, with a higher prevalence of statin prescriptions among men.

Digital Object Identifier (DOI)

10.1186/1472-6963-7-68

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