Determinants of physician recognition and follow-up of abnormal laboratory values

Potential determinants of physician recognition and follow-up of abnormal laboratory values were studied in the ambulatory primary care setting. Data support the hypothesis that a significant positive association exists between the clinical importance of a laboratory result and physician response. Clinical importance was indicated by degree of abnormality of the laboratory value, the type of test, and the indication for obtaining the test. Response was not significantly associated with type of laboratory report or resident's year of training, but a relationship was shown with resident's National Board scores. A model of 12 laboratory tests was found to be more appropriate for studying recognition and follow-up than one of 30 because of fewer repetitious tests and fewer results of doubtful clinical usefulness. With such a select model, recognition and follow-up of abnormals can be used as process measures of quality of medical care.