title: Do Pediatric Patients Who Receive Care Across Multiple Health Systems Have Higher Levels of Repeat Testing?
abstract: Repetition by clinicians of the same tests for a given patient is common. However, not all repeat tests are necessary for optimal care and can result in unnecessary hardship. Limited evidence suggests that an electronic health record may reduce redundant laboratory testing and imaging by making previous results accessible to physicians. The purpose of this study is to establish a baseline by characterizing repeat testing in a pediatric population and to identify significant risk factors associated with repeated tests, including the impact of using multiple health systems. A population-based retrospective cross-sectional design was used to examine initial and repeat test instances, defined as a second test following an initial test of the same type for the same patient. The study population consisted of 8760 children with 1-25 test claims over a 1-year period. The study setting included all health care service organizations in Minnesota that generated these claims. In all, 17.2% of tests met the definition of repeat test instances, with several risk factors associated with per patient repeat test levels. The incidence of repeat test instances per patient was significantly higher when patients received care from more than 1 health system (adjusted incidence rate ratio 1.4; 95% confidence interval: 1.3-1.5). Repeat test levels are significant in pediatric populations and potentially actionable. Interoperable health information technology may reduce the incidence of repeat test instances in pediatric populations by making prior test results readily accessible. (Population Health Management 2016;19:102-108).
authors.affiliation: 1 Institute for Healthcare Leadership, Intermountain Healthcare , Salt Lake City, Utah.|3 Institute for Health Informatics, University of Minnesota , Minneapolis, Minnesota.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Knighton
authors.affiliation: 2 Research and Sponsored Programs, Children's Hospitals and Clinics of Minnesota , Minneapolis, Minnesota.
authors.forename: Nathaniel R
authors.initials: NR
authors.lastname: Payne
authors.affiliation: 3 Institute for Health Informatics, University of Minnesota , Minneapolis, Minnesota.
authors.forename: Stuart
authors.initials: S
authors.lastname: Speedie
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008910:Minnesota; D012189:Retrospective Studies; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D055815:Young Adult