Pathology test-ordering behaviour of Australian general practice trainees a cross-sectional analysis
In the context of increasing over-testing and the implications for patient safety, to establish the prevalence and nature of pathology test-ordering of GP trainees, and to describe the associations of this test-ordering. A cross-sectional analysis of data from the Registrar Clinical Encounters in Tr...
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Published in | International journal for quality in health care Vol. 27; no. 6; pp. 528 - 535 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Oxford University Press
01.12.2015
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Subjects | |
Online Access | Get full text |
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Summary: | In the context of increasing over-testing and the implications for patient safety, to establish the prevalence and nature of pathology test-ordering of GP trainees, and to describe the associations of this test-ordering.
A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) cohort study.
Five of Australia's 17 general practice regional training providers, encompassing urban-to-very remote practices.
GP trainees.
The number of pathology tests ordered per problem/diagnosis managed.
A total of 856 individual trainees (response rate 95.2%) contributed data from 1832 trainee-terms, 108 759 encounters and 169 304 problems. Pathology test-ordering prevalence was 79.3 tests (95% CI: 78.8-79.8) per 100 encounters, 50.9 (95% CI: 50.6-51.3) per 100 problems, and at least 1 test was requested in 22.4% of consultations. Most commonly ordered was full blood count (6.1 per 100 problems). The commonest problem prompting test-ordering was 'check-up' (18.6%). Test-ordering was significantly associated, on multivariable analysis, with the trainee having worked at the practice previously; the patient being adult, male and new to both trainee and practice; the practice being urban; the problem/diagnosis being new; imaging being ordered; referral being made and follow-up being arranged. Trainees were significantly less likely to order tests for problems/diagnoses for which they had sought in-consultation information or advice.
Compared with the established GPs, trainees order more pathology tests per consultation and per problem managed, and in a higher proportion of consultations. Our findings will inform educational policy to enhance quality and safety in general practice training. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1353-4505 1464-3677 |
DOI: | 10.1093/intqhc/mzv086 |