Laboratory services utilization: a survey of repeat investigations in ambulatory care.
BACKGROUND
Earlier studies have shown that repeat investigations are a common cause of unnecessary duplication of laboratory test procedures. Most of the interventions aimed at reducing the number of repeat investigations have not resulted in long-term improvements. None of these studies, however, assessed utilization of laboratory services by physicians, simultaneously treating the same patient.


METHODS
For a random sample of 1500 patients, we examined laboratory services utilization by physicians during an 8-month period. We counted the number of patients for whom more than one physician ordered laboratory test procedures simultaneously, and to what extent these procedures overlapped.


RESULTS
For 28% of the patients more than one physician had ordered tests. Of all 41,655 tests, 5536 (13%) were repeated by a physician other than the physician who ordered the initial test: 1527 (4%) of the tests were repeated within 5 days. Patients between 70 and 90 years had the highest average number of tests, the highest number of involved physicians, and the smallest mean time between similar tests.


CONCLUSIONS
There is a need for better coordination of care. Improved communication among physicians simultaneously treating a patient may lead to a reduction of repeat investigations.
Department of Medical Informatics, Erasmus University, Rotterdam, Netherlands.
P J
PJ
Branger
R J
RJ
Van Oers
J C
JC
Van der Wouden
J
J
van der Lei
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D006300:Health Services Misuse; D006801:Humans; D007223:Infant; D008875:Middle Aged