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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

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Published on: March 30, 2014

House Officer-Driven Reduction in Laboratory Utilization.

Bernard Tawfik¹, J B Collins¹, Nora F Fino¹

¹From the Department of Internal Medicine, Wake Forest School of Medicine, the Department of Biostatistical Sciences, Wake Forest Baptist Health Performance Improvement, and the Department of Biostatistics and Bioinformatics, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Southern Medical Journal

|January 8, 2016

Summary

This summary is machine-generated.

Providing physicians with laboratory test costs and usage data significantly reduced test orders and expenditures, particularly for trainees. This intervention helps curb unnecessary laboratory utilization.

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Area of Science:

Healthcare Management
Clinical Laboratory Science
Health Economics

Background:

Overutilization of laboratory testing contributes to increased healthcare expenditures.
Physician awareness of laboratory test costs and personal utilization patterns may influence ordering behavior.

Purpose of the Study:

To evaluate if sharing laboratory charge and utilization data with physicians reduces test orders and associated costs.
To assess the impact of this feedback on laboratory testing overutilization.

Main Methods:

Prospective study involving general internal medicine and hospitalist services.
Weekly updates of median laboratory charges and tests ordered per patient/per day (PP/PD) were provided.
Laboratory charges for common discharge diagnoses were analyzed to capture episode-of-care costs.

Main Results:

The resident service showed a statistically significant decrease in laboratory tests ordered PP/PD (-0.389) and charges PP/PD (-$27).
The hospitalist service also saw reductions, though not statistically significant.
Overall, the intervention led to 1464 fewer tests ordered and a $188,000 reduction in charges over 10 weeks.

Conclusions:

Informing physicians about laboratory test costs and their utilization patterns can effectively reduce test orders and expenditures.
This approach is particularly beneficial for reducing laboratory overutilization among physicians in training.