Effect of a controlled feedback intervention on laboratory test ordering by community physicians

Area of Science:

• Health Services Research
• Clinical Pathology
• Medical Education

Background:

• Previous interventions to reduce laboratory test utilization often occurred in academic settings with limited follow-up.
• Effective interventions typically involve multiple strategies, regular reinforcement, peer comparison, and personalized feedback.
• Community physician laboratory test ordering requires targeted intervention strategies.

Purpose of the Study:

• To evaluate the effectiveness of a multifaceted education and feedback program in reducing laboratory test utilization among community physicians.
• To assess the sustainability of intervention effects on physician laboratory test ordering behavior.

Main Methods:

• A randomized controlled trial involving 200 community physicians ordering the most laboratory tests.
• Intervention group received personalized education and peer comparison feedback over two years.
• Time-series analysis of population-based laboratory utilization data before, during, and after the intervention.

Main Results:

• The intervention group showed a significant 7.9% relative reduction in laboratory test utilization compared to controls.
• An absolute reduction of 0.22 tests per visit was observed in the intervention group.
• The reduction in test utilization persisted for over two years after the intervention concluded.

Conclusions:

• A multifaceted education and feedback strategy is effective in decreasing laboratory test utilization by community physicians.
• The observed reduction in laboratory test utilization is significant and persistent.
• This approach offers a viable method for optimizing resource use in community laboratory services.