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

The use of microbiological services in general practice has raised concerns about overtesting and its impact on patient care. This study aimed to describe the patterns and variety of microbiological test requisitions from general practitioner (GP) clinics in the North Denmark Region.

A descriptive analysis was performed using data from the microbiology laboratory information system at Aalborg University Hospital from 2019 to 2023. GP clinics that were active for at least three consecutive years were included. Test requisitions were grouped into nine categories and standardised per 1,000 individuals. Practices exceeding the upper threshold (Q3 + 1.5 × IQR) were identified as outliers.

A total of 690,559 tests from 153 GP clinics were analysed. Urine cultures were the most frequently requested tests (median: 89 per 1,000 individuals annually), whereas respiratory and parasitological specimens were the least common tests (median: 1-2 per 1,000 individuals annually). A total of 54 GP clinics (35.3%) were identified as outliers. Notably, outliers were predominantly associated with less common test categories as follows: respiratory (n = 17), parasitological (n = 13), PCR (n = 12), STD/gynaecological (n = 12) and serology tests (n = 11).

Variability in microbiological test use was substantial, with one-third of GP clinics being identified as outliers. A few GP clinics accounted for most requisitions for less common tests. These findings highlight the need for strengthened diagnostic stewardship in general practice.

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