HOW SHOULD EXCESS ADMISSION LABORATORY TEST UTILIZATION BE CURTAILED - PEDIATRICIANS PREFERENCES

Routine admission casefinding tests are costly and rarely lead to chan ges in management. Strategies have been proposed to decrease them. How ever, it is unclear which tests are considered routine at admission. O ur objectives were to clarify which tests are considered to be routine and to determine which methods of reducing test utilization are most acceptable. Sixty-five physicians from a paediatric teaching hospital were selected by random stratified sampling. A questionnaire was admin istered asking about the role of routine tests and preferences for 6 s trategies to reduce test ordering. Sixty percent of respondents felt t hat more casefinding was occurring than should be, and 89% would agree to a trial of test reduction strategies. Just over half the responden ts felt that hemoglobin determination and urinalysis were routine admi ssion tests; fewer physicians Listed a wide variety of other tests. Ph ysicians who thought that all admissions should be screened were older , graduated earlier, and tended to be community based. Educational str ategies to reduce testing were more acceptable than administrative one s. We conclude that many physicians would support the trial implementa tion of test reduction strategies in childrens' hospitals. Hospitals w ishing to reduce excess admission casefinding should implement educati onal strategies, as physicians prefer these.