Mindemark Mirja, Larsson Anders
Department of Clinical Chemistry, Akademiska sjukhuset, Uppsala, Sweden.
Scand J Clin Lab Invest. 2009;69(4):481-6. doi: 10.1080/00365510902749123.
The aim of this study was to investigate whether continuing education on the optimal use of clinical chemistry testing in primary health care has had any long-term effects on the test-ordering behaviour of the participating physicians.
The effects were monitored using 12 laboratory test ratios. Twenty-three general practitioners at 16 primary health-care centres in the county of Uppsala, Sweden, participated. A sign test was used to evaluate how individual physicians' test-ordering patterns have changed during the 8 years since implementation of the educational programme. Maintained or improved ratios were interpreted as a sustained effect on the primary health-care physician's test-ordering habits.
Eleven out of 12 of the investigated ratios were the same or improved since the time of the short-term follow-up 6 months after the education.
A short continuation course on optimal use of clinical chemistry assays can achieve permanent changes in the test-ordering patterns of primary health-care physicians. These findings highlight education as one possible means towards achieving cost-efficiency and quality in test-ordering.
本研究旨在调查初级卫生保健中临床化学检测优化使用的继续教育是否对参与医师的检测医嘱行为产生任何长期影响。
使用12种实验室检测比率监测效果。瑞典乌普萨拉县16个初级卫生保健中心的23名全科医生参与其中。采用符号检验评估自教育项目实施后的8年里个体医师的检测医嘱模式如何变化。保持或改善的比率被解释为对初级卫生保健医师检测医嘱习惯的持续影响。
自教育后6个月的短期随访以来,所调查的12种比率中有11种保持不变或有所改善。
关于临床化学检测优化使用的短期延续课程可使初级卫生保健医师的检测医嘱模式发生永久性改变。这些发现凸显了教育作为在检测医嘱方面实现成本效益和质量的一种可能手段。