Use of Diagnostic Services by Physicians in Community Practice

This study analyzes the use of diagnostic studies by community physicians. Data from billing claims for outpatient visits by Medicaid recipients in three northeastern Pennsylvania counties during a 38-month period were studied, including 55,420 visits to 336 physicians. The use of outpatient laboratory tests and roentgenograms was correlated with the personal characteristics of the prescribing physicians. When case mix was controlled, analysis by specialty showed that internists ordered approximately the same number of procedures as family physicians, and both groups ordered more procedures than general practitioners. The number of years since medical school graduation showed a statistically significant inverse relationship with laboratory and radiology use. Public school graduates ordered more laboratory tests than private school graduates, and foreign medical graduates ordered more roentgenograms than domestic graduates. Other variables, including size and location of practice, and osteopathic or medical training, were not significantly related to patterns of use.

[1]  J Noren,et al.  Ambulatory medical care: a comparison of internists and family-general practitioners. , 1980, The New England journal of medicine.

[2]  J. K. Cooper,et al.  Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. , 1973, JAMA.

[3]  S. A. Schroeder,et al.  Variation among Physicians in Use of Laboratory Tests II. Relation to Clinical Productivity and Outcomes of Care , 1977, Medical care.

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

[5]  W A Ray,et al.  Prescribing of chloramphenicol in ambulatory practice. An epidemiologic study among Tennessee Medicaid recipients. , 1976, Annals of internal medicine.

[6]  K. N. Williams,et al.  Controlling the use and cost of medical services: the New Mexico Experimental Medical Care Review Organization--a four-year case study. , 1978, Medical care.

[7]  S. Leinhardt,et al.  The cost and length of a hospital stay. , 1976, Inquiry : a journal of medical care organization, provision and financing.

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

[9]  K L White,et al.  Peer review: impact of a system based on billing claims. , 1974, The New England journal of medicine.

[10]  R. Pineault,et al.  The Effect of Medical Training Factors on Physician Utilization Behavior , 1977, Medical care.

[11]  Eleanor Hunter,et al.  Non-Medical Factors Influencing Use of Diagnostic X-ray by Physicians , 1972, Medical care.

[12]  W. Schaffner,et al.  Medicaid Records as a Valid Data Source: The Tennessee Experience , 1976, Medical care.

[13]  W. Schaffner,et al.  Prescribing of tetracycline to children less than 8 years old. A two-year epidemiologic study among ambulatory Tennessee medicaid recipients. , 1977, JAMA.

[14]  J. R. Cole,et al.  The Reputations of American Medical Schools , 1977 .