Organizational Benchmarks for Test Utilization Performance: An Example Based on Positivity Rates for Genetic Tests.
OBJECTIVE
Health care organizations are under increasing pressure to deliver value by improving test utilization management. Many factors, including organizational factors, could affect utilization performance. Past research has focused on the impact of specific interventions in single organizations. The impact of organizational factors is unknown. The objective of this study is to determine whether testing patterns are subject to organizational effects, ie, are utilization patterns for individual tests correlated within organizations.


METHODS
Comparative analysis of ordering patterns (positivity rates for three genetic tests) across 659 organizations. Hierarchical regression was used to assess the impact of organizational factors after controlling for test-level factors (mutation prevalence) and hospital bed size.


RESULTS
Test positivity rates were correlated within organizations.


CONCLUSIONS
Organizations have a statistically significant impact on the positivity rate of three genetic tests.
From the Department of Pathology and Harvard Medical School, Massachusetts General Hospital, Boston.
Joseph
J
Rudolf
Center for Effective Medical Testing, Department of Pathology, University of Utah, Salt Lake City.
Brian R
BR
Jackson
School of Nursing, University of Utah Health Sciences Center, Salt Lake City.
Andrew R
AR
Wilson
Center for Effective Medical Testing, Department of Pathology, University of Utah, Salt Lake City.
Kristi J
KJ
Smock
Center for Effective Medical Testing, Department of Pathology, University of Utah, Salt Lake City.
Robert L
RL
Schmidt
D000046:Academic Medical Centers / Q000458:organization & administration; D019985:Benchmarking / Q000458:organization & administration*; D015331:Cohort Studies; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D019851:Thrombophilia / Q000175:diagnosis* / Q000235:genetics
Benchmark; Coagulation; Genetic tests; Test positivity rate; Utilization