title: Do malpractice concerns, payment mechanisms, and attitudes influence test-ordering decisions?
abstract: 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.
authors.affiliation: Department of Neurology, Michigan State University, East Lansing, USA. Gretchen.Birbeck@ht.msu.edu
authors.forename: G L
authors.initials: GL
authors.lastname: Birbeck
authors.forename: D R
authors.initials: DR
authors.lastname: Gifford
authors.forename: J
authors.initials: J
authors.lastname: Song
authors.forename: T R
authors.initials: TR
authors.lastname: Belin
authors.forename: B S
authors.initials: BS
authors.lastname: Mittman
authors.forename: B G
authors.initials: BG
authors.lastname: Vickrey
mesh_terms: D000367:Age Factors; D001291:Attitude of Health Personnel; D003675:Defensive Medicine; D003955:Diagnostic Tests, Routine / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008318:Malpractice; D008875:Middle Aged; D009042:Motivation; D009422:Nervous System Diseases / Q000175:diagnosis; D009462:Neurology / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D012051:Reimbursement Mechanisms; D014481:United States