A trial of two strategies to modify the test-ordering behavior of medical residents.

We studied two methods to reduce the ordering of laboratory and radiologic tests by medical residents in their first postgraduate year. Dividing the residents into three groups, we compared the effect of concurrent chart review and discussion in one group with the effect of a moderate financial incentive for limited ordering of tests in a second group. The third group of residents served as a concurrent control, and data on the testing patterns of residents at the same hospital during the year before the study provided a retrospective control.

[1]  R. Conn.  Clinical laboratories. Profit center, production industry or patient-care resource? , 1978, The New England journal of medicine.

[2]  J. Eisenberg,et al.  Computer-based Audit to Detect and Correct Overutilization of Laboratory Tests , 1977, Medical care.

[3]  P. Griner,et al.  Use of the laboratory in a teaching hospital. Implications for patient care, education, and hospital costs. , 1971, Annals of internal medicine.

[4]  T Colton,et al.  Inputs into coronary care during 30 years. A cost effectiveness study. , 1974, Annals of internal medicine.

[5]  P. Griner.  Use of laboratory tests in a teaching hospital: long-term trends: reductions in use and relative cost. , 1979, Annals of internal medicine.

[6]  M. Greenlick,et al.  Determinants of medical care utilization: physicians' use of laboratory services. , 1972, American journal of public health.

[7]  S. Goldfarb,et al.  Clinical usefulness of measuring prothrombin time as a routine admission test. , 1976, Clinical chemistry.

[8]  A. Weinstein,et al.  Routine blood cultures from febrile outpatients. Use in detecting bacteremia. , 1976, JAMA.

[9]  D S O'Leary,et al.  Differences in laboratory use and length of stay between university and community hospitals. , 1977, Journal of medical education.

[10]  J. Eisenberg,et al.  An educational program to modify laboratory use by house staff. , 1977, Journal of medical education.

[11]  D. E. Rogers,et al.  Medical technology -- a different view of the contentious debate over costs. , 1979, The New England journal of medicine.

[12]  S. Schroeder,et al.  Financial Incentives to Perform Medical Procedures and Laboratory Tests: Illustrative Models of Office Practice , 1978, Medical care.