Evidence map›Paper›PMID 39645252›Full record

ArticleBMJ open2024

Utilisation and trends of laboratory testing and point-of-care testing in primary care in Germany: an analysis of claims data.

Robby Markwart, Josephine Storch, Jutta Bleidorn, Antje Freytag

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Robby MarkwartInstitute of General Practice and Family Medicine, Jena University Hospital, Jena, Thüringen, Germany robby.markwart@med.uni-jena.de.ORCID http://orcid.org/0000-0003-0338-3433
Josephine StorchInstitute of General Practice and Family Medicine, Jena University Hospital, Jena, Thüringen, Germany.ORCID http://orcid.org/0000-0002-4250-0973
Jutta BleidornInstitute of General Practice and Family Medicine, Jena University Hospital, Jena, Thüringen, Germany.
Antje FreytagInstitute of General Practice and Family Medicine, Jena University Hospital, Jena, Thüringen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesGerman general practitioners (GPs) either order laboratory tests from external laboratories (initiated laboratory services (ILS)) or perform point-of-care tests (POCTs) within the GP practice. This study investigated the current use and time trends of laboratory testing in German GP practices with a particular focus on POC testing.

designRetrospective consecutive cross-sectional study by analysis of complete outpatient healthcare claims data (2017-2022).

settingPrimary care in Thuringia, a federal state in central Germany.

participantsData from 2061 GPs. PRIMARY AND SECONDARY OUTCOME MEASURES: Number of performed laboratory analyses per year, mean number of laboratory analyses per patient and year.

resultsIn 2022, 1601 GPs performed 16.1 million laboratory analyses, with 14.9 million (92.5%) being ILS and 1.2 million (7.5%) being POCTs conducted within GP practices. The mean number of laboratory tests per patient was 15.5 in 2022. The number of laboratory tests performed per patient decreased by 18.8% from 2017 to 2022. An especially pronounced reduction was observed in the use of POCTs (-36.0%). During the whole study period, the most common initiated laboratory analyses included creatinine, blood cell count, glucose, thyroid-stimulating hormone and HbA1/HbA1c. The most frequently employed POCTs were glucose, urine test strip, prothrombin time/international normalised ratio, HbA1/HbA1c, erythrocyte sedimentation rate and microalbuminuria. POC testing instead of ILS was more likely performed in older patient groups (≥40 years) compared with young adult patients (18-39 years) (adjusted OR (aOR) 40-59 years: 1.19 (95% CI 1.14 to 1.24); aOR 60-79 years: 1.48 (95% CI 1.40 to 1.57); aOR >79 years: 1.43 (95% CI 1.34 to 1.54)).

conclusionsGerman GPs regularly employ laboratory testing, primarily utilising external laboratory service, while POC testing plays a relatively minor role. The notable decline in the use of POCT testing may be attributed to several factors, including regulations from healthcare authorities, reimbursement guidelines and increasing test costs.

Indexed as

Point-of-Care TestingPrimary Health CareAdolescentAdultAgedChildClinical Laboratory TechniquesCross-Sectional StudiesFemaleGeneral PractitionersGermanyHumansMaleMiddle AgedPractice Patterns, Physicians'Retrospective StudiesFamilyGENERAL MEDICINE (see Internal Medicine)Primary Care

Identifiers

PMID39645252
PMCPMC11628953

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.