Summary
Background
There has been an increase in the number of pathology tests claimed by pathologists per episode in recent years. The extent to which this reflects a change in the ordering behaviour of general practitioners (GPs) and the extent to which any such change relates to changes in the characteristics of practicing GPs and/or other factors has been questioned.
Aims
To describe changes in the pathology-ordering behaviour of GPs and to investigate the extent to which these changes are related to changes in the characteristics of the GP population, the morbidity under management, other management behaviour and the length of consultation.
Preliminary material: Foreword; List of tables; List of figures; Acknowledgements
Summary
Introduction
- Background
- Aims
Methods
- BEACH methods
- Statistical methods
- The final data sets
Changes over time in GP pathology ordering rates
- Changes in total pathology ordering rates over time
- Changes in pathology ordering rates over time excluding Pap smears
Changes over time in the characteristics of GPs
- Changes in the characteristics of BEACH participants over time
- Changes in the characteristics of GPs in the national sample frame over time
GP characteristics and pathology ordering rates
- Pathology test rates over all encounters and all problems
- Pathology test ordering rates after the decision to order pathology
- Summary of findings
- Do any changes in GP age and sex over time explain the increase in pathology test orders over the same period?
The purpose for which pathology tests are ordered
- Distribution and rates of pathology tests by class
- The proportion of problems tested in each class
- Discussion
Pathology ordering and problems managed
- Pathology test ordering rates for selected problems over time
- Problems most likely to generate 4 or 5 test orders, over time
The relationship between pathology ordering and other management
- The relationship between pathology ordering and prescribing
- The relationship between imaging and pathology ordering
- The relationship between therapeutic procedures and pathology orders over time
- The relationship between provision of clinical treatments and pathology ordering
- Conclusion
The relationship between length of consultation and pathology ordering
- Pathology ordering and Medicare item number recorded
- Length of consultation (in minutes) and pathology ordering rates
Analysis of variance in pathology ordering rates
- Univariate analysis
- Multiple regression modelling
Discussion
Conclusion
End matter: References; Glossary; Abbreviations
Appendices
- Appendix 1: Example of a recording form (1998-99)
- Appendix 2: GP characteristics questionnaire (1998-99)
- Appendix 3: Code groups from ICPC-2 and ICPC-2 PLUS used in this report