title: A review on laboratory tests' utilization: A trigger for cutting costs and quality improvement in health care settings.
abstract: BACKGROUND
  Considering the role of laboratory tests as a central part of controlling health expenditure, this study intends to investigate laboratory tests overutilization in Iran to pave the way for future interventions.
  
  
  METHODS
  Inappropriate laboratory utilization was reviewed in a cross-sectional survey through the retrospective analysis of 384 medical records at a tertiary center. To pave the way for future intervention, overutilization tests were classified into two categories, inappropriate and inefficient, and then they were analyzed. Frequency analysis was used to analysis patient's age, gender, hospital wards, length of stay, and diagnosis as well as inappropriate test and inefficient tests.
  
  
  RESULTS
  A total of 143 (1.50 %) of the tests were inefficient and was ordered due to laboratory errors including hemolysis, inefficient sampling, or absurd results. 2522 (26.40%) of the tests were inappropriate and stem from failure to meet medical/clinical appropriateness criteria.
  
  
  CONCLUSIONS
  Whereas, inappropriate test ordering was more frequent than inefficient tests, the initial improvement strategy should focus on physicians' test ordering behavior through conducting proper teaching strategies, ongoing audit and educational feedback, implementing health information technology tools and employing laboratory practice guidelines (LPGs) and testing algorithms. Conducting continuous quality improvement cycle for laboratory services and training of personnel involved in blood sampling is recommended for inefficient tests.
authors: PhD, Assistant Professor, Health Information Management Research Center, Department of Health Information Management & Technology, School of Allied Health, Kashan University of Medical Sciences, Kashan, Iran. meydani-za@kaums.ac.ir.
authors: Zahra
authors: Z
authors: Meidani
authors: PhD, Associate Professor, Health Information Management Research Center, Department of Health Information Management & Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran. farzandipour_m@kaums.ac.ir.
authors: Mehrdad
authors: M
authors: Farzandipour
authors: MD, Assistant Professor, Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. farrokhian_ar@kaums.ac.ir.
authors: Alireza
authors: A
authors: Farrokhian
authors: MSc of Health Information Technology, Health Information Management Research Center, Department of Health Information Management & Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran. masome23haghighat@yahoo.com.
authors: Masomeh
authors: M
authors: Haghighat
keywords: Algorithms; Health Expenditures; Hemolysis; Laboratories; Quality Improvement; Utilization review