papers

Do pediatric patients who receive care across multiple health systems have higher levels of repeat testing?

Popul Health Manag.

Intermountain Healthcare, Salt Lake City, UT, USA; University of Minnesota , Minneapolis, MN, USA; Children’s Hospitals and Clinics of Minnesota , Minneapolis, MN, USA

Repetition by clinicians of the same tests for a given patient is common. However, not all repeat tests are necessary for optimal care and can result in unnecessary hardship. Limited evidence suggests that an electronic health record may reduce redundant laboratory testing and imaging by making previous results accessible to physicians. The purpose of this study is to establish a baseline by characterizing repeat testing in a pediatric population and to identify significant risk factors associated with repeated tests, including the impact of using multiple health systems. A population-based retrospective cross-sectional design was used to examine initial and repeat test instances, defined as a second test following an initial test of the same type for the same patient. The study population consisted of 8760 children with 1-25 test claims over a 1-year period. The study setting included all health care service organizations in Minnesota that generated these claims. In all, 17.2% of tests met the definition of repeat test instances, with several risk factors associated with per patient repeat test levels. The incidence of repeat test instances per patient was significantly higher when patients received care from more than 1 health system (adjusted incidence rate ratio 1.4; 95% confidence interval: 1.3-1.5). Repeat test levels are significant in pediatric populations and potentially actionable. Interoperable health information technology may reduce the incidence of repeat test instances in pediatric populations by making prior test results readily accessible.

Researchers Andrew J. Knighton, PhD, CPA, Nathaniel R. Payne, MD, and Stuart Speedie, PhD at Intermountain Health Care in Salt Lake City Utah sought to identify the risk factors associated with repeat tests in a pediatric population and the impact of using multiple health systems.  Using the ACG system they characterized repeat testing in a pediatric population of 8,760 children with 1-25 test claims over a 1-year period. A population-based retrospective cross-sectional design was used to examine initial and repeat test instances, defined as a second test following an initial test of the same type for the same patient. As would be expected, repeat test instances per patient were significantly higher when patients received care from more than one health system. As health information technology improves and health systems can more easily and readily share test results, the incidence and risk of repeat tests should decrease.

PMID: 26086359