Clinical outcome indicators, disease prevalence and test request variability in primary care

• Published in: Annals of clinical biochemistry 2011-03, Vol.48 (2), p.155-158
• Main Authors: O'Kane, Maurice J, Casey, Lee, Lynch, P L Mark, McGowan, Noel, Corey, John
• Format: Article
• Language: English
• Subjects: Clinical Chemistry Tests - statistics & numerical data; Diabetes Mellitus - epidemiology; Diabetes Mellitus - metabolism; Humans; Hypothyroidism - epidemiology; Hypothyroidism - metabolism; Outcome Assessment (Health Care) - statistics & numerical data; Primary Health Care - statistics & numerical data; Quality Control
• ISSN: 0004-5632; 1758-1001
• DOI: 10.1258/acb.2010.010214

Aim To describe differences in biochemistry test request rates (adjusted for practice size) between general practices and to investigate whether differences in HbA1c and thyroid function test request rates are related either to the practice prevalence of hypothyroidism and diabetes or to Quality and Outcome Framework (QOF) scores. Methods Information on test request rates, prevalence of diabetes and hypothyroidism, and QOF data over a one-year period were obtained from 58 practices covering a population of 284,609 patients. Spearman's rank correlation tests were used to investigate relationships between adjusted test request rates. Results There was wide variability in adjusted test request rates (lowest for HbA1c and highest for immunoglobulins). The ranking of practices for different tests was highly correlated. There was no relationship between adjusted test request rates for HbA1c and thyroid function and the reported prevalence of diabetes and hypothyroidism, respectively, nor was there any relationship with QOF scores in diabetes and hypothyroidism. Conclusions There is wide variability in test request rates in general practice that do not appear to be related to disease prevalence or crude clinical outcome measures.