Changing patterns of routine laboratory testing over time at children's hospitals.

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  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 101271025 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1553-5606 (Electronic) Linking ISSN: 15535592 NLM ISO Abbreviation: J Hosp Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2022- : Hoboken, NJ : Wiley
      Original Publication: Hoboken, NJ : John Wiley & Sons, 2006-
    • Subject Terms:
      Hospitals, Pediatric* ; Diagnostic Tests, Routine*/statistics & numerical data ; Diagnostic Tests, Routine*/trends; Humans ; Retrospective Studies ; Child ; Child, Preschool ; Infant ; Female ; Male ; Adolescent ; Infant, Newborn ; Length of Stay/statistics & numerical data ; Patient Readmission/statistics & numerical data
    • Abstract:
      Background: Research into low-value routine testing at children's hospitals has not consistently evaluated changing patterns of testing over time.
      Objectives: To identify changes in routine laboratory testing rates at children's hospitals over ten years and the association with patient outcomes.
      Design, Settings, and Participants: We performed a multi-center, retrospective cohort study of children aged 0-18 hospitalized with common, lower-severity diagnoses at 28 children's hospitals in the Pediatric Health Information Systems database.
      Main Outcomes and Measures: We calculated average annual testing rates for complete blood counts, electrolytes, and inflammatory markers between 2010 and 2019 for each hospital. A >2% average testing rate change per year was defined as clinically meaningful and used to separate hospitals into groups: increasing, decreasing, and unchanged testing rates. Groups were compared for differences in length of stay, cost, and 30-day readmission or ED revisit, adjusted for demographics and case mix index.
      Results: Our study included 576,572 encounters for common, low-severity diagnoses. Individual hospital testing rates in each year of the study varied from 0.3 to 1.4 tests per patient day. The average yearly change in hospital-specific testing rates ranged from -6% to +7%. Four hospitals remained in the lowest quartile of testing and two in the highest quartile throughout all 10 years of the study. We grouped hospitals with increasing (8), decreasing (n = 5), and unchanged (n = 15) testing rates. No difference was found across subgroups in costs, length of stay, 30-day ED revisit, or readmission rates. Comparing resource utilization trends over time provides important insights into achievable rates of testing reduction.
      (© 2024 Society of Hospital Medicine.)
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    • Grant Information:
      K12 TR004412 United States TR NCATS NIH HHS; PEDSnet Scholars Training Program; K08HS028845 Agency for Healthcare Research and Quality; UM1 TR004399 United States TR NCATS NIH HHS; K08 HS028845 United States HS AHRQ HHS
    • Publication Date:
      Date Created: 20240421 Date Completed: 20240802 Latest Revision: 20241023
    • Publication Date:
      20241023
    • Accession Number:
      PMC11296890
    • Accession Number:
      10.1002/jhm.13372
    • Accession Number:
      38643414