Munk Jens K, Hansen Margrethe F, Buhl Henrik, Lind Bent S, Bathum Lise, Jørgensen Henrik L
Department of Clinical Biochemistry, Hvidovre Hospital, Hvidovre, Denmark.
Department of Clinical Biochemistry, Hvidovre Hospital, Hvidovre, Denmark.
Clin Biochem. 2022 Feb;100:55-59. doi: 10.1016/j.clinbiochem.2021.11.002. Epub 2021 Nov 11.
As healthcare costs continue to rise throughout the world, critical assessment of the appropriateness of expenses gain focus.
We aimed to describe the developments in test numbers of the 10 most frequently requested tests, and to simulate the effect of introducing minimal retesting intervals.
DESIGN & METHODS: Data from the blood tests - albumin, alanine transaminase, cholesterol, creatinine, C-reactive protein, hemoglobin, hemoglobin A, potassium, sodium, and thyrotropin - from 2,687,589 patients handled by the Capital Region of Denmark from 2010 to 2019 was used. Tallies of each test per year were graphed. A simulation of the effect of minimal retesting intervals on test count and blood sampling volume was performed by virtually removing requests made prior to a set of possible minimal retesting intervals.
Increases in requests were observed both from hospitals and general practitioners. The number of requests for hemoglobin A increased more than the other tests. The increases could not be accounted for by an increase in population size and aging of the population, and therefore suggests possible inappropriate increase in monitoring of patients. The simulated effect of applying minimal retesting intervals showed large reductions in tests and blood sampled.
For hospitals, the simulation suggested that applying minimal retesting intervals could lead to significant reductions in both the number of blood tests performed and in the amount of blood drawn for testing. For general practitioners, the simulation showed only minimal reductions in number of tests and blood volume drawn.
随着全球医疗成本持续上升,对费用合理性的严格评估成为焦点。
我们旨在描述10种最常要求进行的检查项目的检查次数变化情况,并模拟引入最短重新检测间隔的效果。
使用了丹麦首都地区在2010年至2019年期间处理的2,687,589名患者的血液检查数据——白蛋白、丙氨酸转氨酶、胆固醇、肌酐、C反应蛋白、血红蛋白、糖化血红蛋白、钾、钠和促甲状腺激素。绘制了每年每项检查的计数图表。通过虚拟删除在一组可能的最短重新检测间隔之前提出的请求,对最短重新检测间隔对检查次数和采血量的影响进行了模拟。
医院和全科医生提出的请求均有增加。糖化血红蛋白的请求增加幅度超过其他检查。这些增加不能用人口规模的增加和人口老龄化来解释,因此表明对患者的监测可能存在不适当的增加。应用最短重新检测间隔的模拟效果显示检查次数和采血量大幅减少。
对于医院,模拟表明应用最短重新检测间隔可导致进行的血液检查次数和用于检测的采血量显著减少。对于全科医生,模拟显示检查次数和采血量仅略有减少。