EFFECT OF FEEDBACK ON TEST ORDERING BEHAVIOR OF GENERAL-PRACTITIONERS

被引:59
作者
WINKENS, RAG
POP, P
GROL, RPTM
KESTER, ADM
KNOTTNERUS, JA
机构
[1] UNIV LIMBURG,DEPT GEN PRACTICE,6200 MD MAASTRICHT,NETHERLANDS
[2] UNIV LIMBURG,DEPT MED INFORMAT & STAT,6200 MD MAASTRICHT,NETHERLANDS
关键词
D O I
10.1136/bmj.304.6834.1093
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective - To assess the effects of feedback on the test ordering behaviour of general practitioners. Design - Comparison of requests at two diagnostic centres, and internal comparison between tests which were discussed in feedback and tests which were not. Setting - A diagnostic centre in Maastricht giving feedback and another elsewhere in the Netherlands (laboratory A) not giving feedback. Subjects - All 85 general practitioners in the region of Maastricht, and all general practitioners in the region of laboratory A. Main outcome measures - Numbers of tests requested by general practitioners. Results - Requests at the Maastricht diagnostic centre decreased soon after the onset of feedback whereas there was a persistent increase in requests at laboratory A. Tests that were discussed showed the strongest decrease (maximum 40%), though tests that were not discussed decreased as well (maximum 27%). Conclusions - Feedback on diagnostic requests may exert a strong influence on request behaviour. Four years after the onset of feedback the effects were still noticeable.
引用
收藏
页码:1093 / 1096
页数:4
相关论文
共 19 条
[1]   INAPPROPRIATE USE OF LABORATORY SERVICES - LONG-TERM COMBINED APPROACH TO MODIFY REQUEST PATTERNS [J].
BAREFORD, D ;
HAYLING, A .
BRITISH MEDICAL JOURNAL, 1990, 301 (6764) :1305-1307
[2]   FEEDBACK REDUCES TEST USE IN A HEALTH MAINTENANCE ORGANIZATION [J].
BERWICK, DM ;
COLTIN, KL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1986, 255 (11) :1450-1454
[3]   CHANGING TEST ORDERING BEHAVIOR - A RANDOMIZED CONTROLLED TRIAL COMPARING PROBABILISTIC REASONING WITH COST-CONTAINMENT EDUCATION [J].
DAVIDOFF, F ;
GOODSPEED, R ;
CLIVE, J .
MEDICAL CARE, 1989, 27 (01) :45-58
[4]   COST CONTAINMENT AND CHANGING PHYSICIANS PRACTICE BEHAVIOR - CAN THE FOX LEARN TO GUARD THE CHICKEN COOP [J].
EISENBERG, JM ;
WILLIAMS, SV .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1981, 246 (19) :2195-2201
[5]  
EISENBERG JM, 1977, J MED EDUC, V52, P578
[6]  
ENDE J, 1983, JAMA-J AM MED ASSOC, V250, P770
[7]  
Fleiss JL., 1981, STAT METHODS RATES P, V2
[8]  
FOWKES FGR, 1986, LANCET, V1, P367
[9]   STRATEGIES TO MODIFY THE TEST-REQUESTING PATTERNS OF CLINICIAN [J].
FRASER, CG ;
WOODFORD, FP .
ANNALS OF CLINICAL BIOCHEMISTRY, 1987, 24 :223-231
[10]   A REVIEW OF PHYSICIAN COST-CONTAINMENT STRATEGIES FOR LABORATORY TESTING [J].
GROSSMAN, RM .
MEDICAL CARE, 1983, 21 (08) :783-802