Comparing cost effects of two quality strategies to improve test ordering in primary care: a randomized trial

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Wim H J M VerstappenTrudy van der Weijden

Abstract

To determine the costs and cost reductions of an innovative strategy aimed at improving test ordering routines of primary care physicians, compared with a traditional strategy. Multicenter randomized controlled trial with randomization at the local primary care physicians group level. Primary care: local primary care physicians groups in five regions of the Netherlands with diagnostic centers. Twenty-seven existing local primary care physicians groups, including 194 primary care physicians. The test ordering strategy was developed systematically, and combined feedback, education on guidelines, and quality improvement sessions in small groups. In regular quality meetings in local groups, primary care physicians discussed each others' test ordering behavior, related it to guidelines, and made individual and/or group plans for change. Thirteen groups engaged in the entire strategy (complete intervention arm), while 14 groups received feedback only (feedback arm). Running costs, development costs, and research costs were calculated for the intervention period per primary care physician per 6 months. The mean costs of tests ordered per primary care physician per 6 months were assessed at baseline and follow-up. The new strategy was ...Continue Reading

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