Iliadi V, Kastanioti C, Maropoulos G, Niakas D
Department of Medical Biopathology, General Hospital of Athens Laiko, Athens, Greece.
Hippokratia. 2012 Jul;16(3):261-6.
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.
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+9.
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.
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.
全球范围内，实验室检测的需求和成本都在增加。似乎相当一部分所要求的检测并未遵循已发布的指南。鉴于血脂水平是心血管疾病风险的决定因素，建议对全体人群进行血脂检测。针对不同人群已有相应的发布指南。本研究旨在评估希腊雅典一家三级教学医院住院患者中，对血脂实验室检测过度需求的数量和成本。
通过修订血脂检测指南，将检测判定为不恰当。通过收集医院检测结果数据库中的数据，研究血脂血液水平的实验室检测需求。该研究在2008年10月至12月这三个月期间进行，共审查了3279名住院患者的20698项检测。
本研究结果与国际观察结果一致，显示出相当比例的临床不恰当实验室检测及其带来的财务负担。在这三个月期间，不恰当重复进行的血脂检测达7938项，医院为此花费了12680欧元。几乎一半的住院患者每月接受检测超过两次。
从所研究病房的某些情况可以看出，医生的行为是一个重要因素。在开具血脂检测医嘱时未遵循指南。已证明采用低成本策略减少这些过度的实验室检测是可行的，这将给患者和医院都带来可观的益处。
