PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of hsresearchLink to Publisher's site
 
Health Serv Res. 1985 December; 20(5): 525–547.
PMCID: PMC1068900

Physicians' use of laboratory, radiology, and drugs in a prepaid group practice HMO.

Abstract

Use by physicians of medical care resources to treat similar patients and morbidities has implications for the efficiency and effectiveness of medical care. This study examined the variation in primary care physicians' use of outpatient laboratory, radiology, drugs, and hospital admissions; the relationships among the uses of these resources by physicians; and uses of these resources by physicians over time. The setting was a large HMO and the physicians were internists (n = 30), pediatricians (n = 20), and obstetrician/gynecologists (n = 17). Resource use was a dollar rate for laboratory, radiology, and drug, and an admission rate per contact for the hospital. The physicians' use rates were derived from the computerized utilization record of a sample of HMO members for 1976-1978. Substantial variation occurred in the rates of use of each resource by physicians in each specialty. The relationships among the resource rates were similar for internists and pediatricians, and were somewhat stronger than expected clinically. There were also substantial consistencies over time in the levels of use of laboratory and drugs by internists and pediatricians. Findings suggest a potential for more judicious use of ambulatory care resources by primary care physicians in this setting.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.9M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rossiter LF, Wilensky GR. A reexamination of the use of physician services: the role of physician-initiated demand. Inquiry. 1983 Summer;20(2):162–172. [PubMed]
  • Schroeder SA, Kenders K, Cooper JK, Piemme TE. Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. JAMA. 1973 Aug 20;225(8):969–973. [PubMed]
  • Lyle CB, Applegate WB, Citron DS, Williams OD. Practice habits in a group of eight internists. Ann Intern Med. 1976 May;84(5):594–601. [PubMed]
  • Freeborn DK, Baer D, Greenlick MR, Bailey JW. Determinants of medical care utilization: physicians' use of laboratory services. Am J Public Health. 1972 Jun;62(6):846–853. [PubMed]
  • Pineault R. The effect of prepaid group practice on physicians' utilization behavior. Med Care. 1976 Feb;14(2):121–136. [PubMed]
  • Eisenberg JM, Nicklin D. Use of diagnostic services by physicians in community practice. Med Care. 1981 Mar;19(3):297–309. [PubMed]
  • Childs AW, Hunter ED. Non-medical factors influencing use of diagnostic x-ray by physicians. Med Care. 1972 Jul-Aug;10(4):323–335. [PubMed]
  • Greenlick MR, Freeborn DK, Gambill GL, Pope CR. Determinants of medical care utilization: the role of the telephone in total medical care. Med Care. 1973 Mar-Apr;11(2):121–134. [PubMed]
  • Daniels M, Schroeder SA. Variation among physicians in use of laboratory tests. II. Relation to clinical productivity and outcomes of care. Med Care. 1977 Jun;15(6):482–487. [PubMed]
  • Schroeder SA, Schliftman A, Piemme TE. Variation among physicians in use of laboratory tests: relation to quality of care. Med Care. 1974 Aug;12(8):709–713. [PubMed]
  • Hurtado AV, Greenlick MR. A disease classification system for analysis of medical care utilization, with a note on symptom classification. Health Serv Res. 1971 Fall;6(3):235–250. [PMC free article] [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust