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实验室检查的合理应用——医学方面

[Appropriate use of laboratory tests--medical aspects].

作者信息

Monsen Anne-Lise Bjørke, Gjelsvik Roar, Kaarbøe Oddvar, Haukland Hanne Husom, Sandberg Sverre

机构信息

Laboratorium for klinisk biokjemi, Haukeland Universitetssjukehus, 5021 Bergen.

出版信息

Tidsskr Nor Laegeforen. 2008 Apr 3;128(7):810-3.

Abstract

BACKGROUND

There has been a large increase in the use and costs of laboratory tests during recent years. Several reports have indicated excessive and inappropriate use. The purpose of this study was to assess the use of public laboratory services within clinical chemistry in two Norwegian health regions.

MATERIAL AND METHODS

Production statistics for 2004 were obtained through a questionnaire sent to all public clinical chemistry hospital laboratories in northern and western Norway. Additional detailed production statistics were obtained from Haukeland University Hospital for 2002-04.

RESULTS

We observed differences in the absolute frequency of requested tests and a marked variation in relative ratios (ratio between related tests) between the laboratories in northern and western Norway. Data from Haukeland University Hospital showed a mean increase of 12% (range: -24-54%) in the number of ordered tests between 2002-04.

INTERPRETATION

There are no known differences in morbidity between the northern and western health regions that can explain the observed variations in the use of laboratory tests. Our observations indicate a need for a thorough investigation of current utilisation of laboratory tests. Initiatives should be taken on a national basis to improve appropriate use.

摘要

背景

近年来,实验室检测的使用和成本大幅增加。几份报告指出存在过度和不当使用的情况。本研究的目的是评估挪威两个卫生区域临床化学领域公共实验室服务的使用情况。

材料与方法

通过向挪威北部和西部所有公共临床化学医院实验室发送问卷,获取2004年的生产统计数据。另外,从豪克兰大学医院获得了2002 - 2004年的详细生产统计数据。

结果

我们观察到挪威北部和西部实验室之间所要求检测的绝对频率存在差异,且相关检测之间的相对比率(相关检测之间的比值)有显著变化。豪克兰大学医院的数据显示,2002 - 2004年期间所订购检测数量平均增加了12%(范围:-24% - 54%)。

解读

挪威北部和西部卫生区域在发病率方面不存在已知差异,无法解释所观察到的实验室检测使用差异。我们的观察结果表明,需要对当前实验室检测的使用情况进行全面调查。应在全国范围内采取措施,以促进合理使用。

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