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Approaches to Computer Monitoring of Clinical Laboratory Utilization

By Ruth E. Dayhoff, Robert E. Miller, Peter E. Dans and Robert C. Rock


Laboratory testing accounts for a significant part of the total health care costs in the United States today. Though it is widely held that some laboratory testing is unwarranted, it has been difficult to identify specific instances of overutilization. Numerous strategies for identifying and controlling laboratory overutilization have been proposed and a few have been implemented, with varying degrees of success. Prototype methodologies have been developed at The Johns Hopkins Hospital using percentage test abnormality rates and patterns of repeat testing as quantitative indicators of laboratory overutilization. Data from studies of emergency serum calcium, amylase, and bilirubin testing and from studies of repeated serum calcium determinations are presented. Such studies provide insight into patterns of laboratory overutilization and should aid physicians in decreasing inappropriate laboratory use at Johns Hopkins Hospital and elsewhere

Topics: Laboratory Testing
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