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

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

Siri Fauli () and Geir Thue

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 GPís 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 GPís stated importance of HPRT, the location of the general practice, the GP recommending sick leave, the GPís stated probability that Mrs Hansenís 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 patientsí 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; (follow links to similar papers)

JEL-Codes: I12; (follow links to similar papers)

74 pages, June 7, 2009

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