Displaying Cost and Completion Time for Reference Laboratory Test Orders-A Randomized Controlled Trial.
Appl Clin Inform
; 13(3): 656-664, 2022 05.
Article
en En
| MEDLINE
| ID: mdl-35580621
ABSTRACT
OBJECTIVES:
Reduction in unnecessary services is one strategy for increasing the value of health care. Reference laboratory, or send-out, tests are associated with considerable costs. We investigated whether displaying cost and turnaround time (TAT), or time-to-result, for reference laboratory tests at the time of order entry in the electronic health record (EHR) system would impact provider ordering practices.METHODS:
Reference laboratory test cost and TAT data were randomized prior to the study and only displayed for the intervention group. A 24-month dataset composed of 12 months each for baseline and study periods was extracted from the clinical data mart. A difference-in-differences (DID) analysis was conducted using a linear mixed-effects model to estimate the association between the intervention and changes in test-ordering patterns.RESULTS:
In the inpatient setting, the DIDs of aggregate test-order costs and volume were not different among the control and intervention groups (p = 0.31 and p = 0.26, respectively). In the ambulatory setting, the DIDs of aggregate test-order costs and volume were not different among the control and intervention groups (p = 0.82 and p = 0.51, respectively). For both inpatient and ambulatory settings, no significant difference was observed in the DID of aggregate test-order costs and volumes calculated in respect to stratified relative cost and TAT groups (p > 0.05).CONCLUSION:
Lack of alternative tests, test orders placed at a late step in patient management, and orders facilitated by trainees or mid-level providers may have limited the efficacy of the intervention. Our randomized study demonstrated no significant association between the display of cost or TAT display and ordering frequency.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Pautas de la Práctica en Medicina
/
Pacientes Internos
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Humans
Idioma:
En
Revista:
Appl Clin Inform
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos