scholarly journals Primary care use of laboratory tests in Northern Ireland’s Western Health and Social Care Trust: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026647
Author(s):  
Magda Bucholc ◽  
Maurice O’Kane ◽  
Ciaran Mullan ◽  
Siobhan Ashe ◽  
Liam Maguire
Keyword(s):  
Northern Ireland ◽  
Laboratory Test ◽  
Laboratory Tests ◽  
Social Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics ◽  
Health And Social Care ◽  
Test Ordering

ObjectivesTo describe the laboratory test ordering patterns by general practitioners (GPs) in Northern Ireland Western Health and Social Care Trust (WHSCT) and explore demographic and socioeconomic associations with test requesting.DesignCross-sectional study.SettingWHSCT, Northern Ireland.Participants55 WHSCT primary care medical practices that remained open throughout the study period 1 April 2011–31 March 2016.OutcomesTo identify the temporal patterns of laboratory test ordering behaviour for eight commonly requested clinical biochemistry tests/test groups in WHSCT. To analyse the extent of variations in laboratory test requests by GPs and to explore whether these variations can be accounted for by clinical outcomes or geographical, demographic and socioeconomic characteristics.ResultsThe median number of adjusted test request rates over 5 consecutive years of the study period decreased by 45.7% for urine albumin/creatinine ratio (p<0.000001) and 19.4% for lipid profiles (p<0.000001) while a 60.6%, 36.6% and 29.5% increase was observed for HbA1c(p<0.000001), immunoglobulins (p=0.000007) and prostate-specific antigen (PSA) (p=0.0003), respectively. The between-practice variation in test ordering rates increased by 272% for immunoglobulins (p=0.008) and 500% for HbA1c(p=0.0001). No statistically significant relationship between ordering activity and either demographic (age and gender) and socioeconomic factors (deprivation) or Quality and Outcome Framework scores was observed. We found the rural–urban differences in between-practice variability in ordering rates for lipid profiles, thyroid profiles, PSA and immunoglobulins to be statistically significant at the Bonferroni-adjusted significance level p<0.01.ConclusionsWe explored potential factors of the interpractice variability in the use of laboratory tests and found that differences in requesting activity appear unrelated to either demographic and socioeconomic characteristics of GP practices or clinical outcome indicators.

scholarly journals Primary care use of laboratory tests in Northern Ireland’s Western Health and Social Care Trust: a cross-sectional study

2019 ◽  
Author(s):  
Magda Bucholc ◽  
Maurice J O’Kane ◽  
Ciaran Mullan ◽  
Siobhan Ashe ◽  
Liam Maguire
Keyword(s):  
Laboratory Test ◽  
Social Care ◽  
Median Number ◽  
Cross Sectional Study ◽  
Practice Variation ◽  
Cross Sectional ◽  
Outcome Indicators ◽  
Health And Social Care ◽  
General Practices ◽  
Test Ordering

AbstractObjectivesTo describe the laboratory test ordering patterns by general practitioners (GPs) in Northern Ireland Western Health and Social Care Trust (WHSCT) and establish demographic and socio-economic associations with test requesting.DesignCross-sectional study.SettingWestern Health and Social Care Trust, Northern IrelandParticipants55 WHSCT general practices requesting laboratory tests in the period from 1 April 2011 to 31 March 2016OutcomesTo identify the temporal patterns of laboratory test ordering behaviour for 8 commonly requested clinical biochemistry tests/test groups in WHSCT. To analyse the extent of variations in laboratory test requests by GPs and to determine whether these variations can be accounted for by clinical outcomes or geographical, demographic, and socioeconomic characteristics.ResultsWe identified substantial changes in the median number of request rates over five consecutive years of the study period as well as a large variation of adjusted test request rates for individual tests (lowest for electrolyte profiles, liver profiles, and HbA1c and highest for immunoglobulins). No statistically significant relationship between ordering activity and either demographic (age and gender) and socioeconomic factors (deprivation) or Quality and Outcome Framework (QOF) scores was observed. We found that practice setting accounted for some of the between-practice variation in test requesting. Rural practices were characterized by both higher between practice variability and median number of order tests than urban practices at all time points.ConclusionsA large between-practice variation in GP laboratory test requesting appears unrelated to demographic and socioeconomic indicators of the practices or crude clinical outcome indicators, most likely reflects differences in the clinical practice of individuals, potentially amenable to change through clinical interventions.Strengths and limitations of this studyThe study provides a comprehensive analysis of temporal changes in laboratory test utilization patterns and establishes the extent of variability in test requesting activity across general practices in Northern Ireland’s Western Health and Social Care Trust.The substantial variation in test ordering, not related to demographic and socioeconomic characteristics of practices, practice location or clinical outcome indicators, may reflect inappropriate laboratory test utilization and hence, suggest a potential for more efficient demand management of laboratory services.Given a cohort of general practices within one catchment area, our results provide evidence of differences in behaviour of individual GPs when managing patients with similar clinical symptoms.Failure to collect and cross-tabulate data on characteristics of general practitioners (GPs), such as GP’s age, years of experience, medical training was a study limitation and a missed opportunity in assessing the influence of practitioner factors on the variation in test ordering behaviour.

Urinary incontinence between 12 and 24 months postpartum: a cross-sectional study nested in a Brazilian cohort from two cities with different socioeconomic characteristics

2019 ◽  
Vol 30 (6) ◽  
pp. 1003-1011
Author(s):  
Pedro Sergio Magnani ◽  
Heloisa Bettiol ◽  
Antonio Augusto Moura da Silva ◽  
Marco Antonio Barbieri ◽  
Ricardo de Carvalho Cavalli ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics ◽  
Two Cities ◽  
Brazilian Cohort

scholarly journals Demographic and socioeconomic characteristics of Canadian medical students: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rishad Khan ◽  
Tavis Apramian ◽  
Joel Hosung Kang ◽  
Jeffrey Gustafson ◽  
Shannon Sibbald
Keyword(s):  
Medical Students ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics

scholarly journals Portuguese Family Physicians’ Awareness of Diagnostic and Laboratory Test Costs: A Cross-Sectional Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0137025 ◽  
Author(s):  
Luísa Sá ◽  
Cristina Costa-Santos ◽  
Andreia Teixeira ◽  
Luciana Couto ◽  
Altamiro Costa-Pereira ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Family Physicians ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Population-based Study of Repeat Laboratory Testing

2003 ◽  
Vol 49 (12) ◽  
pp. 1997-2005 ◽  
Author(s):  
Carl van Walraven ◽  
Michael Raymond ◽  
Keyword(s):  
Laboratory Test ◽  
Laboratory Tests ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Databases ◽  
Baseline Testing ◽  
Test Repetition ◽  
Common Laboratory

Abstract Background: Test repetition could be a readily modifiable component of laboratory utilization. Laboratory test repetition has not been rigorously studied at a population-based level. Our objective was to determine the prevalence of, and charges associated with, repetition of eight common laboratory tests. Methods: We performed a cross-sectional study using high-quality, population-based clinical databases that included adults in Eastern Ontario, Canada, between September 1999 and September 2000 for incidence of repeating eight common laboratory tests (hemoglobin, sodium, creatinine, thyrotropin, total cholesterol, HDL-cholesterol, ferritin, and hemoglobin A1C). Tests were classified as potentially redundant if repeated within the test’s baseline testing interval. For creatinine, sodium, and hemoglobin, only tests repeated in the community were considered. For a sensitivity analysis, we varied the repeat interval by 25%, excluded tests repeated by different physicians, and excluded repeats of normal tests. Results: Almost 4 million tests were conducted during the study year. Most tests (76%) were conducted on patients in the community. More than one-half of all people in the population had at least one laboratory test, with an overall testing rate of 367 tests per 100 people per year. Repeat testing within 1 month accounted for 30% of all utilization (109 repeat tests per 100 people per year). Repetition was more common in hospitalized patients, varied extensively among tests, and was concentrated in a limited number of people. For the eight tests included in the study, charges of potentially redundant repetition in adults totaled between $13.9 and $35.9 million (Canadian) annually. Conclusions: Laboratory test repetition is very common, makes up a significant component of overall test utilization, and is costly.

scholarly journals Incidence and predictors of postpartum depression among postpartum mothers in Kuala Lumpur, Malaysia: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259782
Author(s):  
Mohd Izzuddin Hairol ◽  
Sha’ari Ahmad ◽  
Sharanjeet Sharanjeet-Kaur ◽  
Lei Hum Wee ◽  
Fauziah Abdullah ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Household Income ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Kuala Lumpur ◽  
Sectional Study ◽  
Cross Sectional ◽  
Socioeconomic Characteristics ◽  
Postpartum Mothers

Postpartum depression (PPD) is one of the mental health complications that may arise following childbirth. This cross-sectional study explores the association between socioeconomic factors and PPD literacy with PPD incidence in 350 participants (mean age: 30.58±4.72 years) at one to six months postpartum, who attended the Kuala Lumpur Health Clinic from May to October 2020. PPD incidence and literacy were assessed using the validated Malay versions of the Edinburgh Postpartum Depression Scale (EPDS) and the Postpartum Depression Literacy Scale (PoDLiS), respectively. The participants’ socioeconomic characteristics were collected using a self-administered questionnaire. Chi-square tests were performed to determine the association between these factors and PPD incidence. Binary logistic regression models were used to determine the odds ratios (OR). The incidence of postpartum depressive symptoms was 14.29%. Those with low household income were twice likely to have PPD symptoms (OR:2.58, 95% CI:1.23–5.19; p = 0.01) than those with higher incomes. Unemployment (i.e., participants who were housewives/homemakers) was associated with higher PPD incidence (Χ2(2, 350) = 6.97, p = 0.03), but it was not a significant PPD predictor. In conclusion, PPD incidence in the sample of Kuala Lumpur postpartum mothers is significantly associated with low household income. Other socioeconomic characteristics, including PPD literacy, were not significant predictors of PPD incidence.

scholarly journals Early-Onset Schizophrenia in a paediatric population of French psychiatric and medico-social care centres: A cross sectional study

PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236241
Author(s):  
Emmanuelle Dor-Nedonsel ◽  
Marie-Line Menard ◽  
Arnaud Fernandez ◽  
Charlotte Sakarovitch ◽  
Eric Fontas ◽  
...  
Keyword(s):  
Early Onset ◽  
Social Care ◽  
Paediatric Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Early Onset Schizophrenia ◽  
Cross Sectional
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