Unexplained complaints in general practice: prevalence, patients' expectations, and professionals' test-ordering behavior
Autor: | Monique van Velsen, Cathelijne M. van Hasselt, Richard Grol, Geert-Jan Dinant, Trudy van der Weijden |
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Rok vydání: | 2003 |
Předmět: |
Adult
Male medicine.medical_specialty Health Status 03 medical and health sciences 0302 clinical medicine Prevalence Complaint Humans Medicine 030212 general & internal medicine Practice Patterns Physicians' Psychiatry Netherlands Physician-Patient Relations Diagnostic Tests Routine business.industry Communication 030503 health policy & services Health Policy Odds ratio Middle Aged Patient preference Confidence interval Quality of Care [EBP 4] Patient Satisfaction Family medicine General practice Female Observational study Family Practice 0305 other medical science business Psychosocial Test ordering |
Zdroj: | Medical Decision Making, 23, 226-31 Medical Decision Making, 23, 3, pp. 226-31 |
ISSN: | 0272-989X |
Popis: | Item does not contain fulltext OBJECTIVE: To gain insight into general practitioners' (GPs) test-ordering behavior for patients presenting with unexplained complaints. An unexplained complaint's symptoms are not alarming, and there is no plausible medical or psychosocial explanation for it. The Dutch College of General Practitioners (DCGP) recommends a watchful, waiting attitude for test ordering for unexplained complaints. METHODS: Observational, cross-sectional study of 567 doctor-patient consultations performed by 21 GPs. RESULTS: On average, 13% of consultations involved complaints considered unexplained by GPs. Unexplained complaints were positively related to test ordering (adjusted odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.1-5.3), despite the DCGP's recommendation. Patients' expectations about testing influenced test ordering even more (adjusted OR = 4.1, 95% CI 2.2-7.6). DISCUSSION: Unexplained complaints happen daily in general practice. Besides the DCGP's recommendation, factors such as GPs' desire to understand complaints and patients' expectations seem to have impacts. Guideline development and quality improvement projects should respect, next to Bayesian rules, GP- and patient-related determinants of test ordering. |
Databáze: | OpenAIRE |
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