Use of laboratory tests in out-of-hours services in Norway

Objective

To investigate the use of laboratory tests and which factors influence the use in Norwegian out-of-hours (OOH) services.

Design

Cross-sectional observational study.

Setting

Out-of-hours services in Norway.

Subjects

All electronic reimbursement claims from doctors at OOH services in Norway in 2007.

Main outcome measures

Number of contacts and laboratory tests in relation to patients’ and doctors’ characteristics.

Results

1 323 281 consultations and home visits were reported. Laboratory tests were used in 31% of the contacts. C-reactive protein (CRP) was the most common test (27% of all contacts), especially in respiratory illness (55%) and infants (44%). Electrocardiogram and rapid strep A test were used in 4% of the contacts. Young doctors, female doctors, and doctors in central areas used laboratory tests more often.

Conclusion

CRP is extensively used in OOH services, especially by young and inexperienced doctors, and in central areas. Further investigations are required to see if this extensive use of CRP is of importance for correct diagnosis and treatment.Key Words: Clinical chemistry tests, CRP, diagnostic tests, emergency medical services, primary health careA few point-of-care laboratory tests are available for diagnostic use in out-of-hours services in Norway.

• A laboratory test was taken in 31% of all consultations/home calls.
• C-reactive protein (CRP) was the dominating test (27% of all contacts), and the rate was especially high in small children.
• Test use was most frequent in out-of-hours services in central areas and by younger doctors.