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[Hemostasis screening in the emergency laboratory].

M A Fernández¹, Y Mira, F Ferrando

¹Departamento de Biopatología Clínica, Hospital Universitario, La Fe, Valencia.

Sangre

|June 1, 1992

Summary

Laboratory automation increases efficiency but also costs. A study on haemostasis screening found only 48% of tests were warranted, with abnormal results in just 10%, highlighting potential overuse and high costs for limited patient benefit.

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Area of Science:

Clinical Chemistry
Laboratory Medicine
Hematology

Background:

Laboratory automation offers significant benefits for analysts and clinicians, improving efficiency and turnaround times.
However, increased automation has led to a striking rise in test requests and associated costs, particularly in emergency settings.
Haemostasis screening, a recently automated technique, was selected to evaluate its diagnostic utility and economic impact.

Purpose of the Study:

To assess the aim, indication, and economic burden of haemostasis screening tests in a clinical laboratory.
To determine the cost-effectiveness and clinical value of automated haemostasis screening.

Main Methods:

A retrospective study analyzed haemostasis screening requests performed over a 24-hour period in July 1990.
Requests were categorized by indication: diagnostic, pre-surgical, therapeutic, or unknown.
The justification, purpose, and adherence to American Medical Association criteria were examined.

Main Results:

A total of 1,273 haemostasis screening studies were performed, averaging 41 per day.
Only 48% of the requests met warranted criteria based on American Medical Association guidelines.
Abnormal findings, indicating potential clinical relevance, were present in only 10% of the tests.

Conclusions:

The cost of individual haemostasis screening parameters is low, but the overall economic burden is significant relative to the clinical benefit.
Patient history is a more valuable tool for diagnosing hemorrhagic disorders than indirect clotting factor measurements.
The economic burden for the studied month was substantial (985,879 PTA), with a 50% increase in studies observed one year later.

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