The Effect of Price Display on Primary Care Doctors’ Laboratory Test Ordering Behavior in the Public Health Clinics at Wilayah Persekutuan Kuala Lumpur– A Vignette-based Randomized Controlled Study

To assess the effect of providing price information to doctors when ordering laboratory tests to compare the cost and number of tests orderings before and after the intervention. This was conducted in all the public healths clinics ( 12 public health clinics) at Wilayah Persekutuan Kuala Lumpur. Once obtained the permission from the heads of pulbic healths clinics, the doctors’ list was reshuffled according to alphabetical order, and balloted from a box containing numbers by an independent person into either the control or intervention group. All the doctors in the public health clinics were approached individually by the investigator and explained about the study by using Participants Information Sheet. They were encouraged to participate and those consented were recruited in this study. Both the control and intervention groups were given a self-administered study instrument consisted of 3 sections, i.e. sociodemographic data, participant’s profiles and 4 vignette cases in an envelope, given by the investigator face- to-face. The participants were asked to select the appropriate investigations from a list of investigation based on the vignette cases. The intervention group was tendered with the investigation lists with price display, the control group without. The investigations listed in the study instrument consisted of common laboratory investigations ordered in the primary care clinics in Malaysia, e.g. full blood count, renal profile, liver function test, fasting blood sugar, fasting lipid profile etc.This study instrument was designed specifically for this study after reviewing by an expert panel group consisted of four specialists. The study instrument took approximately 15 minutes to complete. This set of study instrument was to be put back into the envelope, sealed it and was collected from the participated doctor at the end of the day. The doctors were encouraged to return the answered study instrument on the same day. Those who could not complete the study instrument on the same day were given reminders, either by calls or by frequent visits to the public health clinics to remind the doctors personally. The study period for each public health clinics was 30 days, from the first day of the distribution of the study instrument. The doctor was considered as a “drop-out” from the study if the study instrument failed to be collected within the 30-days period.