Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-05T11:19:01.817Z Has data issue: false hasContentIssue false
  • English
  • Français

Decision making in general practice: The availability and use of a specific laboratory analysis

Published online by Cambridge University Press:  04 August 2005

Siri Fauli  and
Geir Thue
Siri Fauli
Affiliation:
University of Olso and The Norwegian Medical Association
Geir Thue
Affiliation:
The Norwegian Center for Quality Improvement of Laboratory Services in Primary Care (NOKLUS)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this investigation was to study the effect of general practitioners' (GP's) characteristics on two decisions: whether to have the Helicobacter pylori rapid test (HPRT) in the office laboratory and whether to use this test or a similar hospital-based serological test in a typical clinical situation described in a vignette.

Methods: Discrete choice analysis with binary logit models were used to predict the probability that a general practice has the HPRT, as well as the GP's probability of using the HPRT or a similar test in this clinical situation.

Results: We found that the number of consultations per week has a positive effect on the probability of having the HPRT, indicating that the size of the practice affects the decision to have such a test in the repertoire. Furthermore, four variables significantly increased the probability of using one of the lab tests: more if located in urban practices, more by solo practitioners, more when the GP stated a high probability for H. pylori associated disease, and more when the GP had the rapid test available in the practice. In our analysis, the remuneration system is endogenous and does not have a significant effect on the two decisions.

Conclusions: Our study demonstrates that characteristics of the GP affect the availability and use of a specific laboratory analysis.

Keywords

Discrete choice analysisMedical decision makingPrimary health care
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 3 , July 2005 , pp. 386 - 392
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atherton JC, Blaser MJ. 1999. Helicobacter infections. Available at: http://www.harrisononline.com/server-java/Arknoid/harrisons/1096-7133/Ch156/Page1.htm. Accessed October 19
Ben-Akiva M, Lerman S. 1985. Discrete choice analysis: Theory and application to travel demand. Massachusetts: MIT Press Cambridge;
Dhami MK, Harries C. 2001; Fast and frugal versus regression models of human judgement, Thinking and Reasoning. 7: 5– 27.Google Scholar
Friedman LS. 1999. Helicobacter pylori: What's new. Editorial related to Chapter 284: Peptic ulcer and related disorders. Available at: http://www.harrisononline.com/server-java/Arknoid/harrisons/1096-7133/.../edl1426.htm. Accessed October 19
Gigerenzer G, Goldstein DG. 1996 Reasoning the fast and frugal way: Models of bounded rationality. Psychol Rev. 103: 650– 669.Google Scholar
Greene WH. 1993. Econometric analysis. Englewood Cliffs, NJ: Prentice-Hall International;
Greene WH. 1998. LIMDEP version 7.0. Users manual.. Australia: Econometric Software;
Grytten J, Sørensen RJ. 2001 Type of contract and supplier-induced demand for primary physicians in Norway. J Health Econ. 20: 379– 393.Google Scholar
Jones TV, Gerrity MS, Earp J. 1990 Written case simulations: Do they predict physicians' behaviour? J Clin Epidemiol. 43: 805– 815.Google Scholar
Kuyvenhoven MM, Jacobs HM, Touw-Otten FW, Van Es JC. 1983 Written simulation of patient-doctor encounters. 1. Research instrument for registration of the performance of general practitioners. Fam Pract. 1: 14– 19.Google Scholar
Peabody JW, Luck J, Glassman P, Dresselhaus TR, Lee M. 2000 2000. Comparison of vignettes, standardized patients and chart abstraction. JAMA. 283: 1715– 1722.Google Scholar
Thue G, Sandberg S. 1994 Survey of office laboratory tests in general practice. Scand J Prim Health Care. 12: 77– 83.Google Scholar