在一所学术医疗中心的门诊实践中实施即时检验
Implementation of point-of-care testing in an ambulatory practice of an academic medical center.
作者信息
Crocker J Benjamin, Lee-Lewandrowski Elizabeth, Lewandrowski Nicole, Baron Jason, Gregory Kimberly, Lewandrowski Kent
机构信息
From the Departments of Medicine and Harvard Medical School, Boston, MA.
Pathology, Massachusetts General Hospital, Boston, and Harvard Medical School, Boston, MA.
出版信息
Am J Clin Pathol. 2014 Nov;142(5):640-6. doi: 10.1309/AJCPYK1KV2KBCDDL.
OBJECTIVES
Point-of-care laboratory testing (POCT) offers reduced turnaround time and may promote improved operational efficiency. Few studies have been reported that document improvements from implementing POCT in primary care.
METHODS
We measured metrics of practice efficiency in a primary care practice before and after implementation of POCT, including the total number of tests ordered, letters and phone calls to patients, and revisits due to abnormal test results. We performed a cost and revenue analysis.
RESULTS
Following implementation of POCT, there was a 21% decrease in tests ordered per patient (P < .0001); a decrease in follow-up phone calls and letters by 89% and 85%, respectively (P < .0001 and P < .0001); and a 61% decrease in patient revisits (P = .0002). Estimated testing revenues exceeded expenses by $6.62 per patient, and potential cost savings from improved efficiency were $24.64 per patient.
CONCLUSIONS
POCT can significantly improve clinical operations with cost reductions through improved practice efficiency.
目的
即时检验（POCT）可缩短周转时间，并可能提高运营效率。很少有研究报告记录在初级保健中实施POCT所带来的改善。
方法
我们在实施POCT前后测量了一家初级保健机构的实践效率指标，包括所开检验的总数、给患者的信件和电话数量，以及因检验结果异常而进行的复诊次数。我们进行了成本和收益分析。
结果
实施POCT后，每位患者的检验数量减少了21%（P < .0001）；随访电话和信件分别减少了89%和85%（P < .0001和P < .0001）；患者复诊次数减少了61%（P = .0002）。估计每位患者的检验收入超过支出6.62美元，因效率提高而潜在节省的成本为每位患者24.64美元。
结论
POCT可通过提高实践效率显著改善临床运营并降低成本。
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