Associations between general practice characteristics and chest X-ray rate: an observational study

Area of Science:

• Oncology
• Public Health
• General Practice

Background:

• Chest X-ray (CXR) is a primary diagnostic tool for lung cancer.
• Prior studies suggest increased CXR utilization correlates with better patient outcomes.

Purpose of the Study:

• To investigate the relationship between general practice characteristics and the frequency of ordering CXRs.
• To identify factors influencing CXR utilization in lung cancer screening.

Main Methods:

• Retrospective observational study of English general practices.
• Analysis of practice data including demographics, smoking prevalence, deprivation, and patient satisfaction.
• Mixed-effects Poisson modeling to assess variations in CXR rates.

Main Results:

• Significant variation in GP CXR rates observed (median 34 per 1000 patients).
• Only 18% of variance in CXR rates explained by recorded practice characteristics.
• Higher rates associated with continuity of care, communication skills, higher smoking prevalence, and specific ethnic groups; lower rates linked to patient satisfaction with access and certain demographics.

Conclusions:

• Substantial unexplained variation exists in CXR ordering rates among general practices.
• Targeted support for practices with lower investigation rates may enhance early lung cancer detection.
• Further research needed to fully understand and address variations in CXR utilization.