Strategies to modify the test-requesting patterns of clinicians

Area of Science:

• Clinical laboratory science
• Health services research
• Medical practice management

Background:

• Clinicians' test-requesting behavior significantly impacts healthcare costs and resource utilization.
• Previous studies have explored various interventions to optimize test ordering practices.
• The effectiveness of these strategies varies, necessitating a review of their impact.

Purpose of the Study:

• To review and evaluate the effectiveness of different strategies aimed at influencing clinicians' test-requesting behavior.
• To identify the most promising approaches for promoting appropriate laboratory test utilization.
• To assess the potential benefits and limitations of each reviewed strategy.

Main Methods:

• Systematic review of studies examining interventions for clinician test-requesting behavior.
• Analysis of strategies including numerical rationing, educational programs, information feedback, financial incentives, clinical budgeting, and policy development.
• Evaluation of impact on test ordering, patient outcomes, and cost-effectiveness.

Main Results:

• Numerical rationing effectively reduces unnecessary repeat testing without harming patient outcomes.
• Educational programs with peer review show temporary positive effects.
• Simple information feedback and direct financial incentives proved ineffectual.
• Agreed requesting policies and problem-oriented request form redesign show promise for improving test appropriateness.

Conclusions:

• While some methods like numerical rationing are effective, others have limited or short-lived impact.
• Collaborative approaches, such as agreed requesting policies and optimized request forms, appear most promising for sustainable improvements.
• Further research is needed to validate the long-term effects and cost-effectiveness of promising strategies like problem-oriented request forms.