title: The utility and financial implications of obtaining routine laboratory screening upon admission for child and adolescent psychiatric inpatients.
abstract: The authors retrospectively explored the utility and fiscal implications of obtaining routine laboratory screening upon admission for child and adolescent psychiatric inpatients. A chart review of 153 sequential admissions (142 unique patients, with 11 patients admitted twice) over a recent 4-month period was conducted. Overall, 97.2% of all subjects who received a screening laboratory test had at least one abnormal finding. However, only four test results (<0.5%) actually had an impact on the psychiatric treatment plan or required immediate medical attention. With an average cost per patient for the full screening battery of $33-$122 and an average yearly direct cost to the inpatient unit of almost $38,000, potential alternatives to routine admission screenings are discussed. Given the cost of this relatively low yield outcome, these findings have important implications for psychiatric practice and cost-benefit analyses, which need to be further evaluated to better determine the actual utility of routine laboratory examinations upon admission.
authors.affiliation: Pennsylvania State Milton S. Hershey Medical Center, Hershey, PA 17033, USA. Lfeldman@hmc.psu.edu
authors.forename: Lance
authors.initials: L
authors.lastname: Feldman
authors.forename: Yixing
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D001523:Mental Disorders; D012189:Retrospective Studies; D014481:United States