Experience with a hospital laboratory admission screen

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Health Services Research

Background:

• Implementing a comprehensive laboratory admission screen requires significant technological infrastructure and interdepartmental cooperation.
• Initial capital investment for equipment is substantial and prone to rapid technological obsolescence.

Purpose of the Study:

• To evaluate the impact of a comprehensive laboratory admission screen on the total number of physician-ordered procedures and overall costs.
• To assess the long-term economic viability of laboratory admission screening in an inflationary environment.

Main Methods:

• Institution of a comprehensive laboratory profile for all admissions.
• Analysis of laboratory procedure orders and associated costs over a three-year period.
• Comparison of costs with and without the admission screening protocol.

Main Results:

• A significant reduction in the total number of laboratory procedures ordered by physicians was observed.
• Despite high initial operating costs, the overall three-year cost approached expected levels without the screen, even with inflation.
• The reduction in procedures ordered was independent of the medical utility of the data generated.

Conclusions:

• Comprehensive laboratory admission screening can effectively reduce the volume of ordered tests.
• While initial costs are high, the long-term economic impact suggests potential cost-effectiveness.
• Advancements in assay technology are expected to further decrease unit costs and expand the scope of unsolicited testing.