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What are tests for? The implications of stuttering steps along the US patient pathway.(Author abstract)

Tritter, Jonathan Q. ; Lutfey, Karen ; Mckinlay, John

Social Science & Medicine, April, 2014, Vol.107, p.37(7) [Tạp chí có phản biện]

ISSN: 0277-9536

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  • Nhan đề:
    What are tests for? The implications of stuttering steps along the US patient pathway.(Author abstract)
  • Tác giả: Tritter, Jonathan Q. ; Lutfey, Karen ; Mckinlay, John
  • Chủ đề: Family Medicine ; Medical Tests
  • Là 1 phần của: Social Science & Medicine, April, 2014, Vol.107, p.37(7)
  • Mô tả: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2014.02.012 Byline: Jonathan Q. Tritter, Karen Lutfey, John McKinlay Abstract: This article explores the implications of how US family physicians make decisions about ordering diagnostic tests for their patients. Data is based on a study of 256 physicians interviewed after viewing a video vignette of a presenting patient. The qualitative analysis of 778 statements relating to trustworthiness of evidence for their decision making, the use of any kind of technology and diagnostic testing suggests a range of internal and external constraints on physician decision making. Test-ordering for family physicians in the United States is significantly influenced by both hidden cognitive processes related to the physician's calculation of patient resources and a health insurance system that requires certain types of evidence in order to permit further tests or particular interventions. The consequence of the need for physicians to meet multiple forms of proof that may not always relate to relevant treatment delays a diagnosis and treatment plan agreed not only by the physician and patient but also the insurance company. This results in a patient journey that is made up of stuttering steps to a confirmed diagnosis and treatment undermining patient-centred practice, compromising patient care, constraining physician autonomy and creating additional expense. Author Affiliation: (a) Department of Sociology and Public Policy, Aston University, Birmingham B4 7ET, United Kingdom (b) Department of Health and Behavioral Sciences, University of Colorado, Denver, United States (c) New England Research Institute, Boston, United States Article History: Received 30 April 2012; Revised 2 February 2014; Accepted 7 February 2014
  • Ngôn ngữ: English
  • Số nhận dạng: ISSN: 0277-9536

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