title: Test-ordering by multiple physicians increases unnecessary laboratory examinations.
abstract: In modern teaching hospitals, patients typically receive direct care from a succession of different physicians, each of whom may order diagnostic tests on the same patient. We examined the association of test-ordering by multiple physicians with unnecessary duplication of 20-test chemistry profiles in 198 consecutively admitted patients. In a multivariate regression model, the number of duplicate chemistry profiles ordered for a patient was significantly correlated with the number of physicians ordering profiles after controlling for the overall intensity of profile testing. In a case-control analysis comparing duplicate with nonduplicate profiles, redundant tests were significantly more likely to have been ordered by a new physician who had not ordered a patient's previous profile than by the same physician who had ordered the previous chemistry panel. We conclude that test ordering by multiple physicians, the prevalent pattern in almost all teaching hospitals, predisposes to unnecessary laboratory examinations.
authors.affiliation: Department of Pathology, State University of New York, Stony Brook.
authors.forename: P
authors.initials: P
authors.lastname: Valenstein
authors.forename: A
authors.initials: A
authors.lastname: Leiken
authors.forename: C
authors.initials: C
authors.lastname: Lehmann
mesh_terms: D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data; D006801:Humans; D010820:Physicians; D012044:Regression Analysis