Do Malpractice Concerns, Payment Mechanisms, and Attitudes Influence Test-Ordering Decisions?

Published in: Neurology, v. 62, no. 1, Jan. 13, 2004, p. 119-121

Posted on RAND.org on December 31, 2003

by Gretchen L. Birbeck, David R. Gifford, J Song, Thomas R. Belin, Brian Mittman, Barbara Vickrey

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Greater understanding is needed of nonclinical factors that determine neurologists' decisions to order tests. The authors surveyed 595 US neurologists and utilized demographic information, attitude scales, and clinical scenarios to evaluate the influence of nonclinical factors on test-ordering decisions. Greater test reliance, higher malpractice concerns, and receiving reimbursement for testing were all associated with a higher likelihood of test ordering. These findings have implications for training needs and suggest malpractice worries may inflate health care costs.

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