title: Use of predefined biochemical admission profiles does not reduce the number of tests or total cost: a randomized-controlled pilot study.
abstract: OBJECTIVE
  The objective of this pilot study was to evaluate whether the use of predefined biochemical profiles as an alternative to individually ordered blood tests by the treating physicians resulted in fewer tests or a lower total cost.
  
  
  METHODS
  This was a randomized-controlled trial of 191 adult patients admitted to a medical admission unit. Upon admission, the patients were randomized to have their blood tests determined by either using a predefined profile (used routinely and designed by the department head) or ordered individually by the treating physician. All patients were initially assessed by junior physicians. We compared the number of tests, estimated total cost, and length of stay. Data are presented as median (interquartile range). Differences were compared using the Wilcoxon rank-sum test and Fishers' exact test.
  
  
  RESULTS
  Ninety-two patients were men, median age 65 years. Patients randomized to the use of the predefined profile had median 17 (14-22) blood tests drawn and patients randomized to physician discretion had median 17 (12-21) tests drawn (P=0.3). The median total cost of tests in the profile group was 618 DKK (493-803) and the cost in the physician group was 564 DKK (434-812) (P=0.19). Length of stay in the profile group was a median of 4 days (2-6 days) and 2 days (2-6 days) in the physician group (P=0.08).
  
  
  CONCLUSIONS
  The use of a predefined blood test panel did not significantly affect the number of tests, total cost, or length of stay for acutely admitted medical patients compared with tests ordered at the discretion of the treating physician.
authors.affiliation: Departments of aMedicine bEndocrinology, Sydvestjysk Sygehus Esbjerg, Esbjerg cDepartment of Medicine, Sygehus Lillebælt Vejle, Vejle, Denmark.
authors.forename: Manan
authors.initials: M
authors.lastname: Pareek
authors.forename: Felix
authors.initials: F
authors.lastname: Haidl
authors.forename: Lars
authors.initials: L
authors.lastname: Folkestad
authors.forename: Mikkel
authors.initials: M
authors.lastname: Brabrand
mesh_terms: D000368:Aged; D003718:Denmark; D003955:Diagnostic Tests, Routine / Q000191:economics*; D004636:Emergency Service, Hospital / Q000191:economics*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies