INTRODUCTION: We sought to investigate whether hospital doctors in Ireland order too many expensive, unnecessary tests and analyse their motives for so doing. METHODS: A series of test patients modelled along guidelines as outlined by the National Institute for Clinical Excellence were presented to doctors in two university teaching hospitals. For each case, they were asked to identify the appropriate investigations. RESULTS: Fifty-three interns on a surgical rotation completed the questionnaires. Forty-four percent (n = 50) of interns ordered the tests based on influences from the consultant leading their team, with only 24% citing their medical training as the critical reason for ordering a preoperative investigation. No intern considered cost to have any influence on their decision to book preoperative tests. DISCUSSION: This study demonstrates that the previously well-documented international practice of overuse and unexplained variation in preoperative testing is also the norm in Ireland.
INTRODUCTION: We sought to investigate whether hospital doctors in Ireland order too many expensive, unnecessary tests and analyse their motives for so doing. METHODS: A series of test patients modelled along guidelines as outlined by the National Institute for Clinical Excellence were presented to doctors in two university teaching hospitals. For each case, they were asked to identify the appropriate investigations. RESULTS: Fifty-three interns on a surgical rotation completed the questionnaires. Forty-four percent (n = 50) of interns ordered the tests based on influences from the consultant leading their team, with only 24% citing their medical training as the critical reason for ordering a preoperative investigation. No intern considered cost to have any influence on their decision to book preoperative tests. DISCUSSION: This study demonstrates that the previously well-documented international practice of overuse and unexplained variation in preoperative testing is also the norm in Ireland.
Authors: O D Schein; J Katz; E B Bass; J M Tielsch; L H Lubomski; M A Feldman; B G Petty; E P Steinberg Journal: N Engl J Med Date: 2000-01-20 Impact factor: 91.245