engleski

The efficiency of test report delivery to the requesting physician in outpatient setting: observational study

Clinical laboratories accredited according to ISO 15189 quality standard are obliged to implement and continuously monitor quality indicators for evaluation of the laboratory's contribution to the patient care. Reporting laboratory results to the requesting physician is one important phase of the clinical laboratory testing process. Failure to notify results may indicate the ineffectiveness of the laboratory service. We aimed to analyze the proportion and type of laboratory reports for outpatients never delivered to the requesting physician. This retrospective observational study was conducted during the 11 months period from January to December 2007 at our outpatient biochemistry laboratory unit. Data on demographic characteristics, request types and laboratory findings for all uncollected reports were retrieved from the laboratory information system and compared with one random two-week representative period. During the study period our laboratory has issued 22, 445 patient reports with more than 150, 000 biochemistry analyses, out of which 464 (2.1%) were uncollected laboratory reports. When compared to representative period, patients who never collected their laboratory reports were younger (P<0.001), predominantly suffering from some chronic disease. Routine biochemistry tests were the most prevalent (>50%). Majority of routine biochemistry tests were almost equally represented during the studied and representative period, while molecular diagnostic tests were several times more frequently uncollected (P<0.001), and reports with electrolytes, metabolites and glucose were the least likely to be uncollected (P<0.001). The total cost for those tests was 30% of the average monthly laboratory budget. Significant amount of laboratory budget is wasted for tests never reaching requesting physician. Such misutilization of laboratory greatly reveals the substantial lack of medical necessity for test requests. Further studies are needed to explore the possible efficiency of the various interventions in reducing the volume of unnecessary and erroneous testing.

accreditation; healthy care efficiency; erroneous test; laboratory report delivery; outpatient setting

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