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Background: For automated high-volume tests, laboratory utilization management addresses questions related to potential under- or over-utilization of these tests and the underlying factors that drive demand. In this analysis we initiated a population-based investigation into the factors associated with the number of Chlamydia (CT) and Gonorrhea (NG) tests ordered.
Methods: Linear regression analysis was used to examine the relationship between number of CT/NG tests ordered (or number of patients represented by these tests) and the number of practitioners (the latter acting as the predictor variable). Tests ordered for HIV, Helicobacter pylori, Herpes Simplex Virus, enteric parasitic infections and Lyme disease were used as comparators. Data was tabulated quarterly representing the years 2010 to 2014. The data was population-based encompassing the Manitoba population of ~1.2 million.
Results: For the time frame of the study, quarterly practitioner numbers varied from app. 2600 to 2900. The relationship between CT/NG tests (or patients) and practitioner number was not linear. As practitioner number increased up to approximately 2800, CT/NG tests correspondingly increased. Past this point, an inverse relationship between practitioner number and number of CT/NG tests was found. For all other pathogens this relationship was not found and tests always increased proportionate to the number of practitioners.
Conclusions: Only CT/NG tests did not show a direct linear relationship between the number of practitioners and the number of tests ordered demonstrating that increasing practitioner number will not necessarily increase the number of CT/NG screen tests ordered. Understanding the factors that drive demand for CT/NG tests requires additional research as does determining whether the plateau in the number of tests ordered represents appropriate, over- or under-utilization relative to the optimum level of testing required for disease control.