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Request of thyroid function tests from Primary Care in Spain.

Maria Salinas1, Maite López-Garrigós1, Francisco J Pomares2

  • 1Servicio de Análisis Clínicos, Hospital Universitario de San Juan, San Juan de Alicante, España; Departamento de Bioquímica y Biología Molecular, Universidad Miguel Hernández, Elche, España.

Endocrinologia Y Nutricion : Organo De La Sociedad Espanola De Endocrinologia Y Nutricion
|November 10, 2015
PubMed
Summary
This summary is machine-generated.

Thyroid function test requests vary significantly across Spanish regions, with higher rates for certain tests in privately managed departments. Implementing strategies could save over €937,000 annually.

Keywords:
AdecuaciónClinical laboratoryLaboratorioPruebas de función tiroideaSuitabilityThyroid function testsVariabilidad clínicaVariability

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Area of Science:

  • Endocrinology
  • Laboratory Medicine
  • Health Services Research

Background:

  • Thyroid function tests are essential for diagnosing and managing thyroid disorders.
  • Understanding regional variations in test ordering is crucial for optimizing healthcare resource allocation.
  • General Practitioners (GPs) play a key role in the initial request of these laboratory tests.

Purpose of the Study:

  • To compare inter-regional variability in laboratory thyroid test requests by GPs in Spain.
  • To investigate potential economic savings by achieving established suitability indicator goals for thyroid testing.

Main Methods:

  • Analysis of test requests per 1,000 inhabitants and test ratios (FT4/TSH, FT3/TSH, TgAb/TPOAb).
  • Comparison of test request patterns across different geographical settings, locations, and management types.
  • Estimation of economic savings based on achieving target suitability indicator ratios (e.g., FT4/TSH ≤ 0.25, FT3/TSH ≤ 0.1).

Main Results:

  • Data from 76 laboratories representing over 17.6 million inhabitants were analyzed.
  • Thyrotropin (TSH) requests were significantly lower in urban-rural areas.
  • Higher requests for free triiodothyronine (FT3), FT3/TSH ratio, and thyroglobulin antibody (TgAb)/thyroid peroxidase antibody (TPOAb) ratio were observed in privately managed departments.
  • Potential annual savings of €937,260.5 were estimated if target test ratios were met.

Conclusions:

  • Significant variability exists in the ordering of thyroid function and autoimmunity tests across Spain.
  • The findings highlight the need for implementing targeted strategies to enhance the appropriate utilization of these laboratory tests.
  • Optimizing test ordering can lead to substantial economic savings within the healthcare system.