Influence of selective vs. panel chemistry tests on cost and diagnostic time.

In the present economy, much concern has been focused on the cost and medical efficacy of laboratory tests being performed. This study examined the difference in laboratory costs associated with physician's use of selective vs. panel chemistries and the frequency of inefficient use of laboratory tests. A determination of the difference in the average number of laboratory visits needed to reach diagnosis associated with the use of these two test methods was made. The study was conducted at a 270-bed community hospital in suburban New York, where the physicians are free to choose selective and/or panel chemistries. Random selection of 200 outpatient records revealed that three types of ordering patterns existed: panels, selective, and a combination of the two. Of the three, panel testing resulted in substantially lower costs and fewer return visits to the laboratory than either selective or mixed (combination of selective and panel) testing.