The development of an adapted Donabedian structure, process and outcomes model to evaluate the influences on prescribing for Diabetes in English National Health Service primary care organisations

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Alexander, Catherine Rose (2018). The development of an adapted Donabedian structure, process and outcomes model to evaluate the influences on prescribing for Diabetes in English National Health Service primary care organisations. University of Birmingham. Other

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Abstract

Prescribing of medicines is a major healthcare cost, subject to multiple influences. This study uses the lens of a Donabedian Structure-Process-Outcome model, to model those influences. The thesis examines the existing literature on the influences on Primary Care Organisation prescribing and assesses the utility of the Donabedian model when applied to prescribing.

Using profiles developed for all Primary Care Organisations in England, differences in prescribing were examined over 3 years to test the utility of this model as a framework to understand prescribing influences. The prescribing of long acting insulin analogues and Glucagon-like-peptide 1 receptor (GLP-1) agonists, were profiled within Primary Care Organisations using the Donabedian model for data for three years from 2011/12 to 2013/14.

This study is the first to apply the Donabedian model to influences on prescribing. This model provided a good fit for all known influences on prescribing, providing an overview of how prescribing habits of an organisation are balanced against other clinical targets in a disease area. Using the Donabedian model could enable organisations to evaluate the effect of changing an influence on prescribing behaviour.

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Thesis (Other)

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Other

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