The association between Asian ethnicity and prescribing rates in east London general practices: a database study

There is currently a paucity of information on the relationship between patient ethnicity and prescribing and its implications for future resource allocation. The proportions of Asian patients on practice lists in east London were estimated by proportional allocation of census data and by assigning ethnicity to names; the latter method was deemed to be more appropriate. Using linear multiple regression modelling, a higher rate of prescribing was demonstrated in general practices with higher proportions of Asian patients. Practices with higher proportions of Asian patients also had higher list sizes per general practitioner (GP). Our findings confirmed that the overall drug prescribing rate was most strongly associated with the age-sex structure of the practice population. Lower prescribing rates were found in training practices and practices with fewer patients per principal. Half the variability in the overall drug prescribing rate was related to the factors included in our analysis. Higher rates of prescribing for patients of Asian origin could reflect higher morbidity, doctor behaviour or patient expectation. To date, ethnicity has not been included in the calculations for general practice Indicative Prescribing Amounts (IPAs). It is suggested that IPAs should be weighted for patient ethnicity. A higher prescribing rate could reflect a greater workload which is consistent with higher consultation rates among Asian patients. These need to be taken into account in General Medical Services (GMS) negotiations.