Practices co-located with pathology collection centres not ordering more tests

January 01, 0001

Practices co-located with pathology collection centres not ordering more tests

The aim of this study by researchers from Australia was to determine whether rates of pathology test ordering by general practitioners in general practices co-located with pathology collection centres (PCCs) are higher than those of GPs in practices located apart from PCCs. The researchers identified all practices in the Melbourne and Sydney metropolitan areas that were co-located with PCCs (same or immediately adjacent suite) and the date co-location was established. This information was merged with the Bettering the Evaluation and Care of Health database to identify samples of GP-patient encounters in co-located practices (n = 31,700) and practices located apart from the nearest PCC (n = 289,700) over the period 2000-2009.

In unadjusted analyses, GPs in co-located practices ordered more pathology tests than GPs in practices located apart from PCCs (40.3 v 37.0 tests per 100 encounters, significant) and had a higher likelihood of ordering one or more tests (16.8% v 15.5% of encounters, significant). After adjusting for other predictors of test ordering, however, neither test-ordering rate (rate ratio, 0.98) nor likelihood of ordering one or more tests per encounter (odds ratio, 1.01) differed significantly by co-location status. Sub-analyses within specific test groups and types showed few systematic differences.

The researchers concluded: ‘Pathology test-ordering rates are not higher in practices co-located with PCCs. To the extent inappropriate commercial influences and relationships exist in the pathology sector, GPs’ test-ordering behaviour may be unaffected."

The wonders of adjusting for predictors.

For the full abstract, click here.

MJA 193(2):114-119, 19 July 2010 © The Medical Journal of Australia 2010
Are rates of pathology test ordering higher in general practices co-located with pathology collection centres? David M Studdert, Helena C Britt, Ying Pan, Salma Fahridin, Clare F Bayram and Lyle C Gurrin. Correspondence to David Studdert: [email protected]

Category: HSR. Health Services Research. Keywords: pathology, test, ordering, rates, general practice, co- location, collection, centres, cohort comparative study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 6 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.