Benchmarking to Identify Practice Variation in Test Ordering: A Potential Tool for Utilization Management.
BACKGROUND
Appropriate test utilization is usually evaluated by adherence to published guidelines. In many cases, medical guidelines are not available. Benchmarking has been proposed as a method to identify practice variations that may represent inappropriate testing. This study investigated the use of benchmarking to identify sites with inappropriate utilization of testing for a particular analyte.


METHODS
We used a Web-based survey to compare 2 measures of vitamin D utilization: overall testing intensity (ratio of total vitamin D orders to blood-count orders) and relative testing intensity (ratio of 1,25(OH)2D to 25(OH)D test orders).


RESULTS
A total of 81 facilities contributed data. The average overall testing intensity index was 0.165, or approximately 1 vitamin D test for every 6 blood-count tests. The average relative testing intensity index was 0.055, or one 1,25(OH)2D test for every 18 of the 25(OH)D tests. Both indexes varied considerably.


CONCLUSIONS
Benchmarking can be used as a screening tool to identify outliers that may be associated with inappropriate test utilization.
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.
Heather
H
Signorelli
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.
Joely A
JA
Straseski
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.
Jonathan R
JR
Genzen
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.
Brandon S
BS
Walker
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT.
Brian R
BR
Jackson
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, UT Robert.Schmidt@hsc.utah.edu.
Robert L
RL
Schmidt
D019985:Benchmarking; D006403:Hematologic Tests / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D007753:Laboratories; D010818:Practice Patterns, Physicians'; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D014600:Utilization Review
benchmarking; laboratory management; laboratory testing; practice variation; test utilization; vitamin D