The influence of cost on medical prescriptions: A comparison of the theory of planned behaviour and the composite attitude behaviour model

Abstract

This is a report on the evaluation of two models, of their ability to explain the influence of cost containment measures of governments and sick funds on the prescription behaviour of physicians. It examines if a set of behavioural intention factors from the model of the theory of planned behaviour by Ajzen, and the composite attitude behaviour model proposed by Eagly and Chaiken, can help predict the behavioural intention of physicians prescribing in a cost conscious environment. The study specified the determinants and compared the predictive power of both models on a random sample of 396 general practitioners and medical specialists in Greece. It tested the effect of strategies to alter prescription behaviour based on the determinants of such behaviour. Real prescription behaviour was measured at pharmacy level. Comparison between the two models showed that the most complex of the models fits the data most adequately. Decomposing the constructs of normative and behavioural beliefs helped generate additional information towards understanding each factor's influence on behavioural intention and behaviour. The decomposed composite attitude behaviour model proved more helpful, in this instance, than that based on the theory of planned behaviour. It is suspected, however, that there are further factors influencing behavioural intention and behaviour that are not covered by either model. The findings have important policy implications both for pharmaceutical companies and for sick funds.

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