Variation in microbiological test requisitions among general practices in the North Denmark Region

Area of Science:

• Medical Microbiology
• General Practice Diagnostics
• Healthcare Management

Background:

• Concerns exist regarding overtesting in general practice and its impact on patient care.
• Microbiological service utilization in primary care requires detailed examination.
• Understanding patterns of test ordering is crucial for optimizing healthcare resources.

Purpose of the Study:

• To describe patterns and variety of microbiological test requisitions from general practitioner (GP) clinics.
• To identify variability in microbiological test ordering among GP clinics in the North Denmark Region.
• To pinpoint potential areas for improved diagnostic stewardship.

Main Methods:

• Descriptive analysis of microbiological test data from 2019-2023.
• Inclusion of GP clinics active for at least three consecutive years.
• Standardization of test requisitions per 1,000 individuals and outlier identification using statistical thresholds.

Main Results:

• Analysis of 690,559 tests from 153 GP clinics.
• Urine cultures were most frequent; respiratory and parasitological tests were least common.
• 35.3% of GP clinics were outliers, predominantly for less common test categories like PCR and serology.

Conclusions:

• Substantial variability exists in microbiological test utilization across GP clinics.
• A small number of GP clinics accounted for the majority of less common test requisitions.
• Findings underscore the necessity for enhanced diagnostic stewardship in general practice.