Hippokratia 2012; 16(3):261-266

V. Iliadi, C. Kastanioti, G. Maropoulos, D. Niakas

Abstract

Background. Demand and costs of laboratory testing are increasing worldwide. It seems that a considerable proportion of the tests requested do not follow the published guidelines. Tests comprising the lipid profile are advised for the entire population, as determinants of cardiovascular risk. Published guidelines exist for different groups of the population. This study is an attempt to assess the volume and the cost of the excessive demand for laboratory measurements of lipids concerning inpatients of a tertiary teaching hospital in Athens, Greece.
Methods. Tests were characterized as inappropriate through revision of guidelines for lipid measurement. The demand for laboratory measurement of lipid blood levels was studied by collecting data from the hospital's test result database. The study was conducted during the trimester October to December 2008 and 20,698 tests from 3,279 inpatients were reviewed.
Results. The results of this study are consistent with international observations showing a significant percentage of clinically inappropriate laboratory tests and the consequent financial burden. The inappropriately repeated lipid tests during the trimester reached the number of 7,938 costing € 12,680 to the hospital. Almost half of the inpatients were tested more than twice a month.
Conclusions. Physicians' behavior is an important factor, as is derived by certain profiles of the wards studied. Guidelines are not followed when ordering lipid tests. Curtailing of these excessive laboratory tests has been shown to be feasible using cheap strategies and will yield considerable benefits for patients and hospitals alike.

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