TH136: Unequal utilization of screening tests in primary health care centers in Sweden: Shoud laboratory professionals be involved?
2014 (English)In: Abstracts: The 3rd EFLM-UEMS Congress, Walter de Gruyter, 2014, eA359-eA359 p.Conference paper, Poster (Other academic)
Introduction: Large differences exist in utilization of laboratory tests among Primary Health Care Centers (PHCC) in Sweden. The NationalBoard of Health and Welfare provides recommendations for the use of laboratory test for population screening. The aim of this study is tocompare and evaluate the use of three different tests performed by PHCCs in relation to national recommendations and disease prevalencein relevant populations, Ferritin-testing among fertile women, Faecal occult blood testing (FOBT) among elderly persons and PSA-screeningamong men. Estimated prevalence in Sweden of depleted iron stores is about 30%, colorectal cancer 1% and prostate cancer 3%.
Method: This is a registry study of test use in 40 PHCCs in a Swedish county. Study populations are limited to women 18-40 years old in thecase of ferritin testing (recommendations non-existant); 60-74 years old for FOBT (should be offered according to national recommendations);and men 50-70 in PSA-screening (should not be actively offered). The number of tests ordered by each PHCC during 2013 was extracted fromthe Östergötland County Council laboratory Medicine information system.
Results: The proportion tested, in the defined populations, varied considerably among PHCCs. With respect to estimated prevalences andcurrent recommendations, we found a general underuse of Ferritin and FOBT-testing, with variations of 1,6-12% and 1-3,6%, respectively, andan overuse of PSA-testing, with a variation of 5-18%.
Conclusions: National recommendations appear to be inadequate as a means of harmonizing test use. Laboratory feedback is one way ofcombating inappropriate testing. Further research should be initiated to strengthen the role of the laboratory and citizen involvement in testutilization. In the case of ferritin-testing, where no recommendations exist, we suggest a “test and counselling” strategy to empower the citizensand increase the proportion of women tested.
Place, publisher, year, edition, pages
Walter de Gruyter, 2014. eA359-eA359 p.
Health Care Service and Management, Health Policy and Services and Health Economy
IdentifiersURN: urn:nbn:se:liu:diva-126607OAI: oai:DiVA.org:liu-126607DiVA: diva2:915857
The 3rd EFLM-UEMS Congress. Laboratory Medicine at the Clinical Interface. Liverpool, UK, 7-10 October 2014