Influencing behavior of physicians ordering laboratory tests: a literature study

P Axt-Adam, J C van der Wouden, E van der Does

Research output: Contribution to journalReview articleAcademicpeer-review

172 Citations (Scopus)


There are various reasons why physicians order laboratory tests. Earlier studies have shown that in many cases test-ordering behavior lacks efficiency, resulting in excessive laboratory utilization. Throughout the years various attempts have been made to improve this situation. This review, based on the literature of the past 20 years, gives a survey of interventions and their effectiveness. Various types of education are discussed: general, cost-control oriented and education by means of guidelines, protocols, decision support systems, and feedback (on test ordering or cost). The discussion addresses the quality and apparent restrictions of the studies, and provides possible causes of the widely varying, but mostly low success rates. The long-term effectiveness of interventions aiming at better laboratory ordering is rather unfavorable.

Original languageEnglish
Pages (from-to)784-94
Number of pages11
JournalMedical Care
Issue number9
Publication statusPublished - Sept 1993
Externally publishedYes


  • Attitude of Health Personnel
  • Clinical Laboratory Techniques/economics
  • Clinical Protocols
  • Cost Control
  • Education, Medical, Continuing
  • Health Services Misuse
  • Humans
  • Motivation
  • Physicians/psychology
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'

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