Leurquin P, Van Casteren V, De Maeseneer J
Institute of Hygiene and Epidemiology, Brussels, Belgium.
Br J Gen Pract. 1995 Jan;45(390):21-5.
Laboratory tests are routine examinations in general practice and are associated with increasing costs in industrialized countries.
The objective of this collaborative study was to determine the differences in general practitioners' use of blood tests in different European countries and to evaluate the relationship between these differences and organizational aspects of the health care system and also characteristics of the participating general practices.
A descriptive study was conducted by eight European sentinel networks. Voluntary participating general practitioners registered all blood tests requested for four weeks, specifying the type of test, and age group and sex of patients. Details of all face-to-face encounters with patients by age group and sex were collected for the same period. Information on the participating practices and general practitioners was collected by questionnaire.
The request rate for blood tests varied considerably between countries. The characteristics of general practitioners and practice were only slightly or were not associated with the use of blood tests while dummy 'country' variables were strongly associated. The number of general practitioners per 1000 inhabitants was the most positively associated variable partly explaining the intercountry variation.
This European study suggests that some national characteristics of the health system could determine the use of blood tests in general practice and underlines the need for further investigation in order to develop successful strategies for promoting the optimal use of diagnostic technology.
实验室检查是全科医疗中的常规检查，在工业化国家其成本不断增加。
这项合作研究的目的是确定欧洲不同国家全科医生血液检查使用情况的差异，并评估这些差异与医疗保健系统的组织层面以及参与研究的全科医疗实践特征之间的关系。
由八个欧洲哨点网络进行了一项描述性研究。自愿参与的全科医生记录四周内所要求的所有血液检查，注明检查类型以及患者的年龄组和性别。同时收集同一时期按年龄组和性别划分的与患者所有面对面诊疗的详细信息。通过问卷调查收集参与实践和全科医生的信息。
不同国家血液检查的申请率差异很大。全科医生和医疗实践的特征与血液检查的使用仅有轻微关联或无关联，而虚拟“国家”变量则有很强的关联。每千名居民中的全科医生数量是最具正相关性的变量，部分解释了国家间的差异。
这项欧洲研究表明，卫生系统的一些国家特征可能决定全科医疗中血液检查的使用情况，并强调需要进一步调查，以便制定促进诊断技术最佳使用的成功策略。
