- Title
- Pathology test-ordering behaviour of Australian general practice trainees: a cross-sectional analysis
- Creator
- Morgan, Simon; Henderson, Kim M.; Magin, Parker J.; Tapley, Amanda; Scott, John; Van Driel, Mieke L.; Spike, Neil A.; Mcarthur, Lawrie A.; Davey, Andrew R.; Oldmeadow, Chris; Ball, Jean
- Relation
- International Journal for Quality in Health Care Vol. 27, Issue 6, p. 528-535
- Publisher Link
- http://dx.doi.org/10.1093/intqhc/mzv086
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2015
- Description
- Objective: 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. Design: A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) cohort study.Setting: Five of Australia's 17 general practice regional training providers, encompassing urban-to-very remote practices.Participants: GP trainees. Main Outcome Measure(s): The number of pathology tests ordered per problem/diagnosis managed. Results: 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. Conclusions: 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.
- Subject
- appropriateness; usage; training; human resources; setting of care
- Identifier
- http://hdl.handle.net/1959.13/1329629
- Identifier
- uon:26206
- Identifier
- ISSN:1353-4505
- Language
- eng
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