Ngo Andy, Gandhi Paras, Miller W Greg
Virginia Commonwealth University, Department of Pathology, Richmond, VA.
J Appl Lab Med. 2017 Jan 1;1(4):410-414. doi: 10.1373/jalm.2016.021634.
Among the variables that influence medical decisions, laboratory tests are considered to be among the most important and frequently used. The influence of laboratory tests on medical decisions has been difficult to estimate. The goal of this study was to estimate the number of patient encounters that included a laboratory test.
We extracted information for 72196 patient encounters from 1-week intervals each quarter of a year from our comprehensive academic medical center electronic medical record. The patients examined represent a comprehensive range of clinical conditions and medical services. We determined for which encounters laboratory and other orders existed.
Overall 35% of encounters had 1 or more laboratory tests ordered. However, the percent varied markedly with patient care areas. For inpatient, emergency department, and outpatient populations, 98%, 56%, and 29%, respectively, had 1 or more laboratory tests ordered.
Our observations support that it is not possible to use a single number to categorize the frequency with which laboratory tests occur in patient encounters. Utilization of laboratory tests varied with type of medical service with almost all inpatients, approximately half of emergency department patients, and nearly one-third of outpatients having laboratory tests during their healthcare visit.
在影响医疗决策的诸多变量中，实验室检查被认为是最重要且最常用的变量之一。实验室检查对医疗决策的影响一直难以评估。本研究的目的是估算包含实验室检查的患者诊疗次数。
我们从综合性学术医疗中心的电子病历中，按每年每季度1周的时间间隔提取了72196次患者诊疗的信息。接受检查的患者涵盖了广泛的临床病症和医疗服务。我们确定了哪些诊疗有实验室检查及其他医嘱。
总体而言，35%的诊疗有1项或更多的实验室检查医嘱。然而，这一比例在不同的患者护理区域有显著差异。对于住院患者、急诊科患者和门诊患者，分别有98%、56%和29%的患者有1项或更多的实验室检查医嘱。
我们的观察结果表明，不可能用一个单一数字来归类患者诊疗中进行实验室检查的频率。实验室检查的使用因医疗服务类型而异，几乎所有住院患者、约一半急诊科患者以及近三分之一门诊患者在其就医过程中都进行了实验室检查。
