Central Laboratory of Haifa and Western Galilee, Clalit Health Services, Nesher, Israel.
Am J Clin Pathol. 2012 Mar;137(3):486-9. doi: 10.1309/AJCPLJFSS62YBAWN.
The purpose of our study was to determine the effect of the elimination of laboratory-initiated reflex testing on physician ordering behavior. In 1999, we stopped laboratory-initiated reflex testing and did microscopic analysis only on physician request. The number of urinalysis dipstick tests, microscopic analysis tests, and urine cultures done during 6-month periods for the next 10 years was extracted from our laboratory information system that includes data from the middle of 1999. The number of physician complaints was also recorded. Before the intervention, we did 106,000 urine analysis tests per 6-month period, with 19,006 microscopic examinations (17.9%) that decreased to less than 0.2% after the change in policy. During the 10-year period, physician requests for microscopic urinalysis decreased gradually to around 50 in any 6-month period.
我们的研究目的是确定消除实验室启动的反射测试对医生开单行为的影响。1999 年，我们停止了实验室启动的反射测试，只在医生要求时进行显微镜分析。接下来的 10 年里，我们从实验室信息系统中提取了每个 6 个月的尿分析试纸检测、显微镜分析检测和尿液培养的数量，该系统包含了 1999 年年中的数据。同时还记录了医生的投诉数量。在干预之前，我们每 6 个月进行 106000 次尿液分析检测，其中 19006 次进行了显微镜检查（17.9%），在政策改变后，这个比例降至不到 0.2%。在 10 年期间，医生对显微镜尿液分析的需求逐渐减少，任何 6 个月期间都减少到 50 次左右。
