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Benchmarking to Identify Practice Variation in Test Ordering: A Potential Tool for Utilization Management.

Heather Signorelli1, Joely A Straseski1, Jonathan R Genzen1

  • 1Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.

Laboratory Medicine
|October 23, 2015
PubMed
Summary
This summary is machine-generated.

Benchmarking helps identify potential overuse of vitamin D tests when guidelines are absent. This method revealed significant variations in vitamin D test ordering practices across facilities.

Keywords:
benchmarkinglaboratory managementlaboratory testingpractice variationtest utilizationvitamin D

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Healthcare Quality Improvement

Background:

  • Evaluating appropriate test utilization is challenging without established medical guidelines.
  • Benchmarking offers a method to detect practice variations that may indicate inappropriate testing.
  • This study explored benchmarking for identifying sites with suboptimal vitamin D test utilization.

Purpose of the Study:

  • To investigate the utility of benchmarking for identifying inappropriate vitamin D test utilization.
  • To compare overall and relative vitamin D testing intensity across different healthcare facilities.

Main Methods:

  • A Web-based survey was employed to collect data from 81 facilities.
  • Two key metrics were compared: overall testing intensity (Vitamin D orders/blood-count orders) and relative testing intensity (1,25(OH)2D orders/25(OH)D orders).

Main Results:

  • The average overall testing intensity was 0.165 (1 Vitamin D test per 6 blood counts).
  • The average relative testing intensity was 0.055 (1 1,25(OH)2D test per 18 25(OH)D tests).
  • Both overall and relative testing intensity indexes demonstrated considerable variation among facilities.

Conclusions:

  • Benchmarking serves as an effective screening tool for detecting outliers in test utilization.
  • Identified outliers may warrant further investigation for potentially inappropriate vitamin D testing practices.