Laboratory test use and primary care physician supply.
OBJECTIVE: To determine the relative effects of population size, FP and GP supply, and other specialist supply on chemistry and hematology test volumes (ie, number of tests performed). DESIGN: Population-level analysis using secondary data from the Calgary Health Zone for 2004 to 2009. SETTING: Calgary, Alta. MAIN OUTCOME MEASURES: The relative effects of population size, FP and GP supply, and other specialist supply on laboratory test use. RESULTS: Population size was the strongest predictor of test volumes in a multivariate analysis. The FP and GP supply was significantly negatively correlated with chemistry test volume (partial r(2) = 0.186, P = .045). There was a trend toward decreasing use of hematology tests with increasing FP and GP supply (partial r(2) = 0.117, P = .119). CONCLUSION: The relationship between FP and GP supply and laboratory test use is complex, but increasing numbers of FPs do not necessarily indicate an increase in laboratory test use and might be associated with a decrease in test use when other factors are controlled for. (+info)
The effect of for-profit laboratories on the accountability, integration, and cost of Canadian health care services.
Canadian public health care systems pay for-profit corporations to provide essential medical laboratory services. This practice is a useful window on the effects of using for-profit corporations to provide publicly funded services. Because private corporations are substantially protected by law from the public disclosure of "confidential business information," increased for-profit delivery has led to decreased transparency, thus impeding informed debate on how laboratory services are delivered. Using for-profit laboratories increases the cost of diagnostic testing and hinders the integration of health care services more generally. Two useful steps toward ending the for-profit provision of laboratory services would be to stop fee-for-service funding and to integrate all laboratory work within public administrative structures. (+info)
A focused ethnographic study of Alberta cattle veterinarians' decision making about diagnostic laboratory submissions and perceptions of surveillance programs.