Department of Radiology, University of Florida Health Center, Gainesville, FL 32610-0374, USA.
Am J Manag Care. 2012 Apr 1;18(4):e135-44.
To examine patient and physician factors affecting utilization of diagnostic imaging in primary care.
DATA SOURCES/STUDY SETTING: Patient-level data from a large academic group practice over the period July 1, 2007, through June 30, 2009.
This is a retrospective cohort study of 85,277 patients cared for by 148 primary care physicians (PCPs). The dependent variable is the number of outpatient imaging exams ordered by each patient's PCP over the study period. Independent variables include 17 patient factors describing both clinical need and demographic characteristics and 7 physician factors.
Data were collected from the electronic medical record and associated administrative databases.
Patient factors having a statistically significant effect on both the probability race, more than 10 medications, congestive heart failure, diabetes, hypertension, other problems, visits to the PCP, visits to specialists, and imaging exams ordered by specialists. For physician factors, experience, gender, and having another degree were statistically significant in both portions of the model.
Both patient and physician factors have a substantial effect on primary care outpatient diagnostic imaging utilization. Several of these significantly influence both the probability that any images will be ordered and the intensity (number) of imaging.
考察影响初级保健中诊断性影像学使用的患者和医生因素。
资料来源/研究场所：2007 年 7 月 1 日至 2009 年 6 月 30 日期间，一家大型学术集团实践中的患者水平数据。
这是对 148 名初级保健医生（PCP）治疗的 85277 名患者进行的回顾性队列研究。因变量是每位患者的 PCP 在研究期间开出的门诊影像检查数量。自变量包括 17 个患者因素，描述了临床需求和人口统计学特征以及 7 个医生因素。
数据来自电子病历和相关管理数据库。
患者因素对两种情况都有统计学意义：种族、使用 10 种以上药物、充血性心力衰竭、糖尿病、高血压、其他问题、就诊次数、就诊专科医生以及专科医生开出的影像学检查。对于医生因素，经验、性别和拥有另一个学位在模型的两个部分都具有统计学意义。
患者和医生因素对初级保健门诊诊断性影像学的使用都有很大影响。其中一些因素显著影响了开出任何影像检查的概率和影像检查的强度（数量）。
