[Excessive use of vitamin D testing in the private health system]

Given the importance of reducing lowvalue care practices and acknowledging that vitamin D testing in the general population is rising despite the absence of evidence to support such conduct, we decided to investigate its overuse.

Design: cross-sectional study.

electronic medical records.

patients aged between 18 and 64 on the Hospital Italiano de Buenos Aires Health Maintenance Organization membership list, to whom at least one test of vitamin D had been performed between July 1st and December 31st 2022. A sample of electronic medical records was manually analyzed. In the presence/suspicion of a clinical condition that counts with recommendation for Vitamin D testing, its indication was considered appropriate; however, in its absence, it was considered inappropriate.

A total of 10 095 vitamin D tests were performed on 9623 patients (mean age 47, 78.1% female). These patients were 10% of the 97 584 HMO members aged between 18 and 64 in 2022. A hundred and sixty of the 242 patients whose electronic medical records were analyzed (66%, CI 95% 60 - 72), did not have a clinical condition that justified vitamin D testing. The most frequent clinical conditions found for testing were osteopenia in 37/242 patients (15%); osteoporosis, 13/242 (5%) and chronic kidney disease 11/242 (5%).

Two-thirds of the vitamin D tests performed did not have a clinical condition that justified the practice. These findings represent an opportunity to design strategies to institutionally reduce this low-value care practice.