LABORATORY SERVICES UTILIZATION - A SURVEY OF REPEAT INVESTIGATIONS IN AMBULATORY CARE

Background: Earlier studies have shown that repeat investigations are a common cause of unnecessary duplication of laboratory test procedure s. Most of the interventions aimed at reducing the number of repeat in vestigations have not resulted in long-term improvements. None of thes e studies, however, assessed utilization of laboratory services by phy sicians, simultaneously treating the same patient. Methods: For a rand om sample of 1500 patients, we examined laboratory services utilizatio n by physicians during an 8-month period. We counted the number of pat ients for whom more than one physician ordered laboratory test procedu res simultaneously, and to what extent these procedures overlapped. Re sults: For 28% of the patients more than one physician had ordered tes ts. Of all 41655 tests, 5536 (13%) were repeated by a physician other than the physician who ordered the initial test: 1527 (4%) of the test s were repeated within 5 days. Patients between 70 and 90 years had th e highest average number of tests, the highest number of involved phys icians, and the smallest mean time between similar tests. Conclusions: There is a need for better coordination of care. Improved communicati on among physicians simultaneously treating a patient may lead to a re duction of repeat investigations.