Effect of provider continuity on test repetition

Area of Science:

• Healthcare Management
• Clinical Laboratory Science
• Health Services Research

Background:

• Provider continuity (PC) is when patients see the same physician over time.
• A perceived benefit of PC is reduced laboratory test repetition.
• Repeat laboratory tests contribute significantly to overall healthcare utilization.

Purpose of the Study:

• To investigate the relationship between provider continuity and laboratory test repetition.
• To determine if decreased provider continuity leads to increased test repetition.

Main Methods:

• A population-based cohort study was conducted in Eastern Ontario, Canada (September 1999-September 2000).
• The study analyzed the probability of repeating 7 common laboratory tests (e.g., hemoglobin, creatinine, cholesterol).
• Statistical adjustments were made for patient, index test, follow-up visit, and physician factors.

Main Results:

• The study included over 881,000 patients and millions of laboratory tests and physician visits.
• Tests were significantly more likely to be repeated when the follow-up physician also ordered the initial test (adjusted odds ratio 2.5-5.9).
• This association remained consistent across most patient subgroups.

Conclusions:

• Provider continuity was associated with an increase, not a decrease, in laboratory test repetition.
• Increasing provider continuity alone may not effectively reduce overall laboratory test utilization.
• Further research is needed to understand the drivers of test repetition in relation to provider continuity.