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Changing patterns of routine laboratory testing over time at children's hospitals
Michael J Tchou1, Matt Hall2, Jessica L Markham3
1Department of Pediatrics, Section of Hospital Medicine, University of Colorado-Anschutz Medical Center and Children's Hospital Colorado, Aurora, Colorado, USA.
Journal of Hospital Medicine
|April 21, 2024
Summary
Routine laboratory testing rates varied significantly across children's hospitals over ten years. Changes in testing frequency did not impact patient outcomes like length of stay or readmission rates.
Area of Science:
- Pediatric healthcare quality improvement
- Laboratory utilization analysis
- Health services research
Background:
- Routine laboratory testing patterns in pediatric care are not well-understood over time.
- Previous research has not consistently evaluated trends in low-value testing at children's hospitals.
Purpose of the Study:
- To analyze changes in routine laboratory testing rates over a decade at children's hospitals.
- To investigate the association between these testing rate changes and patient outcomes.
Main Methods:
- Retrospective cohort study of over 576,000 pediatric hospital encounters (0-18 years) across 28 children's hospitals.
- Analysis of complete blood counts, electrolytes, and inflammatory markers from 2010-2019.
- Hospitals categorized by increasing, decreasing, or unchanged testing rates; outcomes adjusted for demographics and case mix.
Main Results:
- Average annual testing rate changes ranged from -6% to +7% across hospitals.
- No significant differences in length of stay, cost, 30-day readmission, or ED revisits were observed between groups.
- Significant variation in testing rates persisted, with some hospitals consistently high or low.
Conclusions:
- Hospital testing rate trends for common labs did not correlate with patient outcomes.
- Resource utilization insights can guide achievable testing reductions in pediatric settings.
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