Availability of In-Office Laboratory Services and Use of Prostate Specific Antigen Testing

Area of Science:

• Health Services Research
• Clinical Practice Management
• Diagnostic Testing Utilization

Background:

• Concerns exist regarding potential overuse of medical testing due to convenient ancillary services.
• In-office laboratory services may lower evaluation thresholds, leading to unnecessary procedures.

Purpose of the Study:

• To investigate the association between in-office laboratory services and prostate specific antigen (PSA) testing rates.
• To determine if ancillary services influence PSA testing decisions.

Main Methods:

• Analysis of nationally representative 2006-2008 NAMCS data.
• Comparison of practices with and without on-site laboratory services.
• Multivariable logistic regression modeling of PSA testing odds based on mortality risk and lab availability.

Main Results:

• Half of primary care and urology practices offered in-office laboratory services.
• On-site lab availability was not associated with increased PSA testing (OR 0.86).
• Higher mortality risk patients had lower PSA testing rates in practices with on-site labs.

Conclusions:

• Findings suggest in-office ancillary services do not necessarily lead to overuse of PSA testing.
• The study provides reassurance against concerns of increased testing driven by convenience.