[Rationalization of biological tests in cardiology department]

Area of Science:

• Cardiology
• Clinical Diagnostics
• Healthcare Management

Background:

• Laboratory tests are crucial for patient care but are often overprescribed in French hospitals.
• Excessive or unjustified laboratory test prescriptions contribute to rising healthcare costs, particularly in cardiology.
• Understanding the cost and volume of laboratory tests is essential for optimizing healthcare resource allocation.

Purpose of the Study:

• To evaluate the impact of a rationalization policy on laboratory test prescription volumes and costs in a cardiology department.
• To determine if reducing laboratory test utilization affects patient outcomes or safety.
• To demonstrate the financial and operational benefits of evidence-based laboratory test ordering.

Main Methods:

• A prospective study compared two consecutive 2-year periods (2011-2015) before and after implementing a rationalization policy.
• The study focused on the volume and cost of frequently prescribed laboratory tests in cardiology patients.
• Data were collected over four years, analyzing trends in successive half-year periods.

Main Results:

• Rationalization led to significant reductions in laboratory test prescriptions: CBC (-72%), BNP (-92%), troponin (-82%), CRP (-89%), liver tests (-87%), lipid profile (-80%), and TSH (-80%).
• These reductions were statistically significant (p<0.01).
• No increase in adverse events or mortality rates was observed, indicating patient safety was maintained.

Conclusions:

• A policy of rationalizing laboratory test prescriptions can substantially decrease examination volumes and associated costs in cardiology.
• Implementing such policies does not compromise patient care and can be achieved without additional risk.
• This strategy offers a viable approach to optimize healthcare resource utilization in diagnostic testing.