INTRODUCTION The avoidance of repeat chemistry testing such as Complete Blood Count (CBC) and Electrolyte Panel (EP) on clinically stable patients was identified as important utilization goals by Choosing Wisely Canada. The purpose of this study was to assess the volume of overutilization of CBC and EP in an inpatient setting in Alberta, Canada, and provide an estimated cost assessment of unnecessary testing. METHODS The total laboratory testing volumes of two common test panels were collected retrospectively for one-year from January to December 2018. Data was collected on test panels performed in an emergency room (ER) and inpatient setting from three separate Laboratory Information Systems covering the provincial population in Alberta, Canada. Total initial test panel instances, total repeated panels, repeated panels that were previously normal or abnormal, and estimated costs were examined. Cost assessment was completed based on Reference Median Cost (RMC) analysis for each of these two common test panels. RESULTS During the study period, 2,020,467 (CBC) and 1,455,983 (EP) initial test panel instances were recorded, of which 67.7% and 73.5% were repeated for the CBC and EP, respectively. There was a higher proportion of EP repeated inappropriately (previously normal; 35.6%) compared to CBCs (5.4%). The cost to the province for inappropriately repeating CBC and EP were estimated to be RMC $0.52 million and RMC $1.90 million CAD, respectively. CONCLUSION Results from this study can assist policy makers in implementing utilization management initiatives and update clinical practice guidelines to reduce costs to healthcare without compromising patient care.

中文翻译：

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对加拿大艾伯塔省住院患者的全血细胞计数（CBC）和电解质检测板进行了不适当的重复测试。

简介通过选择Wisely Canada，避免对临床稳定的患者进行重复化学测试（例如全血细胞计数（CBC）和电解质小组（EP））已被确定为重要的利用目标。这项研究的目的是评估加拿大艾伯塔省住院患者中CBC和EP过度利用的数量，并提供不必要测试的估计成本评估。方法回顾性地收集了两个常见测试小组的实验室总测试量，时间为2018年1月至2018年12月。为期三年，这些数据来自急诊室（ER）和住院病人环境，分别来自三个覆盖全省的实验室信息系统加拿大艾伯塔省的人口。初始测试小组总数，重复小组总数，重复检查以前正常或异常的面板，并评估成本。基于这两个通用测试面板的参考中位数成本（RMC）分析，完成了成本评估。结果在研究期间，记录了2,020,467（CBC）和1,455,983（EP）的初始测试小组实例，其中CBC和EP分别重复了67.7％和73.5％。与CBC（5.4％）相比，不适当重复的EP比例较高（以前是正常的； 35.6％）。该省因不当地重复CBC和EP而造成的成本估计分别为RMC 52万美元和RMC 190万加元。