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住院患者常规实验室检查的成本和收益:医源性贫血和未诊断的急性肾损伤。

Costs and benefits of routine labs in hospital patients: iatrogenic anaemia and undiagnosed acute kidney injury.

机构信息

Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA

出版信息

BMJ Open Qual. 2024 Oct 23;13(4):e002884. doi: 10.1136/bmjoq-2024-002884.

Abstract

IMPORTANCE

Guidelines recommend avoiding unnecessary laboratory tests to minimise risks of anaemia in hospitalised patients as well as reduce costs, but there are costs to skipping routine labs including missing acute kidney injury.

OBJECTIVE

Quantify the costs and benefits of routine labs in dollar costs as well as mortality.

EVIDENCE REVIEW

This is a retrospective analysis of 48 204 admissions at University of Kentucky Hospitals and simulates different strategies for skipping labs.

FINDINGS

In a simplified estimate of pure dollar costs, the costs of daily labs appear to outweigh the costs of missing acute kidney injury.

CONCLUSIONS AND RELEVANCE

In both dollar costs and the number of patients with mortality effects, the benefits of randomly skipping labs appear to significantly outweigh the costs, but the costs are not insignificant.

摘要

重要性

指南建议避免不必要的实验室检查,以尽量减少住院患者贫血的风险并降低成本,但跳过常规实验室检查会有一些成本,包括漏诊急性肾损伤。

目的

以美元成本和死亡率量化常规实验室检查的成本和收益。

证据综述

这是对肯塔基大学医院 48204 例住院患者的回顾性分析,并模拟了跳过实验室检查的不同策略。

发现

在每日实验室检查的纯美元成本的简化估计中,实验室检查的成本似乎超过了漏诊急性肾损伤的成本。

结论和相关性

在美元成本和死亡率影响的患者数量方面,随机跳过实验室检查的收益似乎明显超过成本,但成本并非微不足道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78b0/11499769/11ebc3665d69/bmjoq-13-4-g001.jpg

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