Scandinavian Working Papers in Economics

HERO Online Working Paper Series,
University of Oslo, Health Economics Research Programme

No 2005:12: Decision-making in General Practice: The importance of laboratory analyses when choosing medical actions

Siri Fauli () and Geir Thue
Additional contact information
Siri Fauli: The Norwegian Medical Association, The Norwegian Quality Improvement of, Postal: P.O.Box 1152 Sentrum, N-0107 Oslo, Norway
Geir Thue: The Norwegian Quality Improvement of Laboratory Services in Primary Care, Postal: P.O.Box 1152 Sentrum, N-0107 Oslo, Norway

Abstract: The focus of this study is the effect of a laboratory analysis and socioeconomic variables on choosing medical actions in a specific situation (a clinical vignette - a young woman, Mrs Hansen, with dyspepsia - presented to GPs). We assume that the GP’s decision depends on what he or she thinks is best for the patients, based on the best clinical evidence available. Significant variables associated with the choice of medical actions are: the result of the Helicobacter pylori (HP) test, the GP’s stated importance of HPRT, the location of the general practice, the GP recommending sick leave, the GP’s stated probability that Mrs Hansen’s symptoms are due to a H.pylori infection after the HP-result is known, and how the GP follows up the patient. Our results show that the HP-analysis has a significant and major influence on the GPs choice of medical actions. Therefore the quality of the analysis is likely to affect the patients’ health and social costs. Hence institutions for quality monitoring and improvement are important elements of health care reforms. Such institutions should balance cost and benefits of quality improving measures, and will be the focus of closer studies in our future research.

Keywords: Discrete choice models; Decision-making; Primary Health Care

JEL-codes: I12

74 pages, June 7, 2009

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