Laboratory Test Utilization and Repeat Testing for Inpatients of Age 80 and Over in Australia: A Retrospective...

Area of Science:

• Geriatric Medicine
• Clinical Pathology
• Health Services Research

Background:

• Repeat laboratory testing is common in hospitals but can be detrimental to elderly patients.
• Understanding patterns of laboratory test ordering and repeat testing is crucial for optimizing care in older adults.

Purpose of the Study:

• To identify the most frequently ordered laboratory tests in older inpatients.
• To determine the repeat testing rates for these common tests among the elderly population.

Main Methods:

• Retrospective observational study of inpatients aged 80 years and over.
• Data collected from four public hospitals in New South Wales, Australia (2008-2013).
• Analysis of laboratory test orders and repeat testing proportions for frequently used tests.

Main Results:

• Five key tests (electrolytes urea and creatinine, complete blood count, calcium magnesium phosphate, liver function test, C-reactive protein) comprised 62% of all tests.
• Significant proportions of repeat tests were performed outside recommended intervals: 41.5% for CRP, 68.2% for CaMgPhos, and 65.2% for LFT.
• Repeat testing showed an exponential increase around 24 hours after the initial test.

Conclusions:

• Compliance with recommended repeat testing intervals for older inpatients is inconsistent.
• Further investigation into the reasons for repeat testing is needed to develop targeted interventions.
• Improving laboratory test utilization can enhance care for elderly inpatients.