A Comparison of Laboratory Testing in Teaching vs Nonteaching Hospitals for 2 Common Medical Conditions

Area of Science:

• Health Services Research
• Hospital Administration
• Medical Education

Background:

• Teaching hospitals are often assumed to utilize more laboratory tests than nonteaching hospitals.
• Limited data exist to robustly support this assumption regarding inpatient laboratory test ordering.

Purpose of the Study:

• To quantify and compare laboratory test utilization between teaching and nonteaching hospitals.
• To investigate the influence of hospital teaching status on laboratory test ordering patterns.

Main Methods:

• A cross-sectional study analyzed a statewide database of adult inpatients with bacterial pneumonia or cellulitis.
• Data from January 2014 to June 2015 included 43,329 hospitalizations across major teaching, minor teaching, and nonteaching hospitals.
• Generalized mixed linear regression models controlled for illness severity, length of stay, and patient demographics.

Main Results:

• Major teaching hospitals ordered significantly more laboratory tests per day for both bacterial pneumonia and cellulitis compared to nonteaching hospitals.
• This difference persisted across all illness severity levels, except for the highest severity in cellulitis cases.
• Statistical models confirmed a significant increase in laboratory tests per day in major teaching hospitals (3.58 for pneumonia, 2.61 for cellulitis).

Conclusions:

• Patients with bacterial pneumonia or cellulitis at major teaching hospitals receive more laboratory tests than those at nonteaching hospitals.
• Findings suggest that the training environment within hospitals may contribute to increased laboratory test utilization.
• Further research is warranted to explore the specific mechanisms driving these differences in resource use.