OBJECTIVES: To verify if the variability observed in prescription of respiratory drugs is related to a different hospital admission rate for respiratory diseases (asthma and chronic obstructive pulmonary disease, COPD). METHODS: We carried out an ecological study in the Local Health Unit of Modena (632,000 inhabitants, 7 districts, 517 general practitioners -GPs- and 40 primary care groups). Every GP, primary care group and district receives two different reports quarterly, both weighted for age and sex. The first report is on drugs prescribed and reimbursed by the National Health System (NHS) and the second one on NHS hospital admissions. For drug consumption, data are retrieved from the 157 retail pharmacies in Modena. The chosen indicators are per person expenditure and defined daily doses (DDD) per 1,000 inhabitants/day. Drugs are examined according to the ATC (Anatomic Therapeutic Chemical) classification. The main indicator for hospital admissions is the number of admissions per 1,000 inhabitants/year. Our preliminary analysis focused on respiratory drugs and hospital admissions for asthma and COPD in Modena districts. RESULTS: In year 2000, overall and per person expenditure for respiratory drugs were €6.614.098 (7.5% of total expenditure) and €10.6, respectively. We observed variability in drug prescription among districts: extreme values were reported for districts of Mirandola, 44.1 DDD per 1000 inhabitants/day, and Carpi, 35.3. Asthma and BPCO admission rates showed a broad variability as well: 3.2 and 3.3 admissions per 1000 inhabitants/year for Carpi and Mirandola, respectively, and 8.4 for Pavullo. Our analysis showed no correlation between drug prescription and hospital admission: districts with similar admission rates (Mirandola and Carpi) reported quite different values in drug prescription. CONCLUSIONS: These preliminary findings are the starting point for more specific analyses that will explore possible determinants of the observed variability in order to increase appropriate use of drugs.