Abstract

Overutilization of tests and treatments is a widespread problem in contemporary heath care, and laboratory medicine is no exception. It is estimated that 10–70% of laboratory tests may be unnecessary, with estimates in the literature varying depending on the situation and the laboratory test. Inappropriate use of laboratory tests can lead to further unnecessary testing, adverse events, inaccurate diagnoses, and inappropriate treatments. Altogether, this increases the risk of harm to a patient, which can be physical, psychological, or financial in nature. Overutilization in healthcare is driven by complex factors including care delivery models, litigious practice environments, and medical and patient culture. Quality improvement (QI) methods can help to tackle overutilization. In this review, we outline the global healthcare problem of laboratory overutilization, particularly in the developed world, and describe how an understanding of and application of quality improvement principles can help to address this challenge.

摘要

测试和治疗的过度使用是当代医疗保健中的一个普遍问题，实验室医学也不例外。据估计，10-70% 的实验室测试可能是不必要的，文献中的估计因情况和实验室测试而异。实验室检测的不当使用会导致进一步不必要的检测、不良事件、不准确的诊断和不适当的治疗。总而言之，这增加了对患者造成伤害的风险，这可能是身体上、心理上或经济上的伤害。医疗保健的过度使用是由复杂的因素驱动的，包括护理提供模式、诉讼实践环境以及医疗和患者文化。质量改进 (QI) 方法有助于解决过度使用问题。在这次审查中，