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Does the computerized display of charges affect inpatient ancillary test utilization?
D W Bates1, G J Kuperman, A Jha
1Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Archives of Internal Medicine
|December 31, 1997
Summary
Displaying test charges to physicians did not significantly reduce ordering for inpatients. More intensive interventions are needed to influence physician test utilization and control healthcare costs.
Area of Science:
- Health economics
- Clinical decision support
- Medical informatics
Background:
- Physician ordering behavior for ancillary tests can be influenced by cost information.
- Previous studies focused on outpatients, leaving inpatient behavior unexamined.
Purpose of the Study:
- To evaluate the impact of computerized charge display on physician ordering of clinical laboratory and radiological tests for inpatients.
- To determine if cost transparency affects test utilization in hospital settings.
Main Methods:
- Conducted two prospective, patient-randomized controlled trials at a large teaching hospital.
- Intervention group received computerized display of test charges at the time of order entry.
- Included over 20,000 inpatients across clinical laboratory and radiological test groups.
Main Results:
- No statistically significant reduction in clinical laboratory or radiological tests ordered per admission.
- Slight, non-significant trends toward fewer clinical laboratory tests and lower charges were observed.
- Radiological test ordering and charges remained virtually unchanged in the intervention group.
Conclusions:
- Computerized display of test charges did not significantly alter physician ordering patterns for inpatients.
- Current interventions may be insufficient to impact physician test utilization effectively.
- Further research into more intensive strategies is warranted to manage test ordering costs.