title: Larger differences in utilization of rarely requested tests in primary care in Spain.
abstract: BACKGROUND
  The study was performed to compare and analyze the inter-departmental variability in the request of rarely requested laboratory tests in primary care, as opposed to other more common and highly requested tests.
  
  
  METHODS
  Data from production statistics for the year 2012 from 76 Spanish laboratories was used. The number of antinuclear antibodies, antistreptolysin O, creatinine, cyclic citrullinated peptide antibodies, deaminated peptide gliadine IgA antibodies, glucose, protein electrophoresis, rheumatoid factor, transglutaminase IgA antibodies, urinalysis and uric acid tests requested was collected. The number of test requests per 1000 inhabitants was calculated. In order to explore the variability the coefficient of quartile dispersion was calculated.
  
  
  RESULTS
  The smallest variation was seen for creatinine, glucose, uric acid and urinalysis; the most requested tests. The tests that were least requested showed the greatest variability.
  
  
  CONCLUSIONS
  Our study shows through a very simplified approach, in a population close to twenty million inhabitants, how in primary care, the variability in the request of laboratory tests is inversely proportional to the request rate.
authors.affiliation: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Salinas
authors.affiliation: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Biochemistry and Molecular Pathology, Universidad Miguel Hernandez, Elche, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: López-Garrigós
authors.affiliation: Clinical Laboratory, Hospital Universitario de San Juan, San Juan de Alicante, Spain ; Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Flores
authors.affiliation: Department of Public Health, Universidad de Alicante, Alicante, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Uris
authors.affiliation: Department of Radiology, University of Virginia, Charlottesville, VA, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Leiva-Salinas
mesh_terms: D002391:Catchment Area, Health; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D006403:Hematologic Tests / Q000706:statistics & numerical data; D006801:Humans; D007159:Immunologic Tests / Q000706:statistics & numerical data; D009313:National Health Programs / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013030:Spain; D016482:Urinalysis / Q000706:statistics & numerical data
keywords: clinical laboratory services; laboratory proficiency testing; preanalytical phase; primary care; test requesting