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Variation in requests for imaging investigations by general practitioners: a multilevel analysis
Wim Verstappen1, Gerben ter Riet, Trudy van der Weijden
1Department of General Practice, Maastricht University, 6500 MD Maastricht, The Netherlands.
Journal of Health Services Research & Policy
|January 26, 2005
Summary
General practitioners (GPs) show significant variation in ordering imaging investigations. Group practice GPs order 34% fewer tests than solo practitioners, with no other factors explaining regional differences.
Area of Science:
- Medical Imaging
- General Practice
- Health Services Research
Background:
- Variation exists in the number of imaging investigations requested by general practitioners (GPs).
- Understanding the drivers of this variation is crucial for optimizing healthcare resource utilization.
Purpose of the Study:
- To quantify the variation in imaging investigation requests among GPs.
- To identify potential explanations for observed variations in test ordering.
Main Methods:
- A cross-sectional survey of 221 GPs across five regions in the Netherlands in 1997.
- Multivariable, multilevel regression analysis linked imaging data with professional and contextual factors.
Main Results:
- Significant inter-regional differences in imaging investigation orders were observed (up to twofold variation).
- GPs in group practices requested 34% fewer imaging investigations compared to those in single-person practices.
- Chest X-rays constituted the largest category of imaging investigations ordered.
Conclusions:
- Practice type is a significant factor associated with the number of imaging investigations requested by GPs.
- No further explanations were identified for the substantial inter-regional differences in test ordering.
- Future research should focus on differentiating contextual from regional factors influencing GP test ordering.