Physician and practice characteristics associated with immunoglobulin test ordering.

Area of Science:

• Clinical Medicine
• Health Services Research
• Laboratory Medicine

Background:

• Primary care serum immunoglobulin test requests are increasing, raising concerns about potential overuse.
• Existing evidence suggests a link between general practitioner (GP) and practice characteristics and higher test ordering rates.

Purpose of the Study:

• To identify specific physician and practice characteristics associated with the ordering of serum immunoglobulin tests in primary care.
• To analyze factors influencing the frequency of immunoglobulin test requests by general practitioners.

Main Methods:

• A retrospective, cross-sectional study utilized routine laboratory data for primary care serum immunoglobulin requests.
• Data were analyzed using mixed-effects multilevel regression models, linking laboratory data with GP patient list information.
• Predictor variables included physician gender, experience, practice region/type, and patient list size and composition.

Main Results:

• A total of 5990 immunoglobulin tests were ordered by 481 GPs in 2013.
• Female GPs (IRR: 1.81) and GPs with less experience (IRR: 2.27) showed significantly higher test ordering rates.
• No significant association was found between practice-level factors and immunoglobulin test ordering.

Conclusions:

• Physician gender and years of experience are key factors associated with serum immunoglobulin test ordering in primary care.
• Further investigation is warranted to explore the underlying reasons for higher test ordering among female GPs and those with less experience.