There was a 20% increase in the number of pathology tests
ordered by GPs between 1998-99 and 2000-01, according to a new
report released today by the Australian Institute of Health and
Welfare and the University of Sydney.
There was no change in the likelihood of a GP ordering pathology
at any given consultation, but when they did order pathology they
ordered more tests.
The report, Changes in Pathology Ordering by GPs in
Australia 1998 to 2001, found that the number of tests (or
groups of tests) ordered rose from 25 to 29 tests per 100
consultations over the three years.
This represents a rise in the annual number of GP-ordered
pathology tests from approximately 180 million to 210 million.
Director of the AIHW General Practice Statistics and
Classification Unit at the University of Sydney, Professor Helena
Britt, said that the rises were indicative of an overall move from
ordering a single test for a problem to multiple test orders.
'When GPs ordered pathology, they ordered an average of 2.1
tests per problem in 2000-01 compared with 1.8 tests per problem in
1998-99', Professor Britt said.
The biggest increases in kinds of tests ordered by GPs were:
full blood counts; lipid tests; glucose, electrolyte, urea and
creatinine tests (EUCs); multibiochemical analysis; and hormone
assays.
The health problems accounting for the most significant
increases in ordered pathology tests were management of heart
disease, diabetes and blood pressure. More tests were also being
ordered for patients with weakness/tiredness, high cholesterol, and
thyroid problems.
The study showed that some GPs order more pathology tests than
others, particularly female GPs, younger GPs, GPs in larger
practices and those working in rural areas.
'The increase in pathology test orders cannot be explained,
however, by changes in the characteristics of the GPs-such changes
were marginal over the period', Professor Britt said.
And the increase could not be explained by changes in the types
of patients or the pattern of problems managed either.
'We must look elsewhere for the reasons. The increase may
reflect improved levels of preventive care, and increased use of
protocols and guidelines for the care of patients with specific
problems, such as diabetes and heart disease.'
'It may also reflect other influences such as increased use of
computers by GPs, or increased fear of litigation by GPs.'
'We really don't know whether increased ordering is a good or a
bad thing in terms of quality of the care provided,' Professor
Britt said.
Information for the study was drawn from over 3000 GPs across
the country, covering 300,000 GP-patient consultations, as part of
the BEACH (Bettering the Evaluation and Care of Health) program, a
continuous national study of general practice activity.
19 November 2003
Further information: A/Prof Helena Britt, tel.
(02) 9845 8150 or 0411 197 938
Media copies of the report: Publications Officer,
AIHW tel. (02) 6244 1032, OR Media Office, University of Sydney, 02
9351 2261
Availability: Check the AIHW
Publications Catalogue for details.