[Variation in the number of diagnostic analyses and tests in a hospital outpatient consulting clinic].
OBJECTIVE
To analyze the variation in the number of diagnostic test orders after physicians have been made aware of the need to order only the necessary tests for adequate patient diagnosis.


METHODS
The study was done in a prospective manner in 3 successive steps during which 750 first-visit patients attending in an outpatient rheumatology clinic at a general hospital were analyzed. In the first step (baseline) data were collected without the physicians' knowledge. The results of the study were later presented at a grand round. In the second step (intervention) data were collected again, this time with the physicians' knowledge. A final data collection (control) was carried out 6 months later without physicians' knowledge again.


RESULTS
In the baseline step 2.355 orders with a mean of 9.42 +/- 5.5 order/patient were done. In the intervention step, there was a reduction of 1,946 orders with a mean of 7.78 +/- 4.48 (p < 0.001). Six months later, in the control step, the number of orders was reduced to 1.806 with a mean of 7.22 +/- 5.16 orders/patient, with a 23.3% saving compared with the baseline step (p < 0.001). Also, significant differences were found in the number or orders among physicians at each step. Reduction was observed in every kind of diagnostic test.


CONCLUSIONS
A considerable reduction of 23.3% in the number of analysis and diagnostic tests can be obtained if physicians are made aware of the need to order only the necessary tests for patients' diagnostic. This strategy may result in a significant containment in the growing health care cost we suffer nowadays.
Rivera
J
J
Servicio de Reumatología, Hospital General Gregorio Marañón, Madrid.
García-Monforte
A
A
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012219:Rheumatology / Q000706:statistics & numerical data; D013030:Spain; D018709:Statistics, Nonparametric