Inappropriately ordered echocardiograms are related to socioeconomic status

Although the appropriateness of ordering tests is increasingly measured, the demographic characteristics of patients receiving inappropriate cardiac tests, such as echocardiograms, have seldom been studied. The authors hypothesized that particular patient characteristics might influence the frequency of inappropriate echocardiogram ordering. Demographics and appropriateness were examined in a consecutive series of 535 inpatients receiving echocardiograms at a metropolitan hospital; inappropriate tests were ordered in 9% of cases. Disabled patients received a significantly higher proportion of inappropriate echocardiograms compared to both retired and employed patients. Among patients receiving repeat echocardiograms, Medicaid patients were significantly more likely to receive inappropriately ordered echocardiograms than patients with either Medicare or private insurance. In conclusion, certain socioeconomic and demographic characteristics are associated with a higher incidence of inappropriate test ordering. Further research into the causal factors behind this association may be useful to reduce inappropriate test ordering.