Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions

Bibliographic Details
Main Author:	Tchou, Michael J., M.D.
Language:	English
Published:	University of Cincinnati / OhioLINK 2018
Subjects:	Surgery laboratory testing electrolyte testing healthcare utilization variation healthcare culture
Online Access:	http://rave.ohiolink.edu/etdc/view?acc_num=ucin1543839434925304

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spelling	ndltd-OhioLink-oai-etd.ohiolink.edu-ucin15438394349253042021-08-03T07:09:05Z Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions Tchou, Michael J., M.D. Surgery laboratory testing electrolyte testing healthcare utilization variation healthcare culture Background: Overuse of laboratory testing contributes substantially to healthcare waste, downstream resource utilization, and patient harm. Understanding variation in testing across hospitals and across common inpatient diagnoses could inform waste reduction efforts.Methods: We conducted a multi-center, retrospective cohort study of pediatric inpatients at 41 children’s hospitals using administrative data from 2010-2016. Initial electrolyte testing was defined as testing occurring within the first 2 days of an encounter, and repeat testing was defined as subsequent testing within an encounter where initial testing occurred. To examine if testing rates correlated across diagnoses at the hospital level, we compared risk-adjusted rates for gastroenteritis to a weighted average of risk-adjusted rates in other diagnosis cohorts. Linear regression was performed to compare initial and subsequent testing.Results: In 497,719 patient encounters, wide variation was observed across hospitals in adjusted initial and repeat testing rates. Hospital-specific rates of testing within gastroenteritis strongly correlated with rates of testing for other diagnoses (initial: r = 0.63, p < 0.001, repeat r = 0.83, p <0.001) such that hospitals who were high-testers in one diagnosis were highly likely to be high-testers in other diagnoses. Higher initial testing rates at hospitals were associated with increased rates of subsequent testing for all diagnoses except gastroenteritis.Conclusions: Initial and repeat electrolyte testing vary widely across 8 common inpatient pediatric diagnoses, and initial testing was associated with higher rates of subsequent testing. Hospitals that test frequently in one diagnosis are more likely to test frequently across other diagnoses. 2018 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1543839434925304 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1543839434925304 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection	NDLTD
language	English
sources	NDLTD
topic	Surgery laboratory testing electrolyte testing healthcare utilization variation healthcare culture
spellingShingle	Surgery laboratory testing electrolyte testing healthcare utilization variation healthcare culture Tchou, Michael J., M.D. Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
author	Tchou, Michael J., M.D.
author_facet	Tchou, Michael J., M.D.
author_sort	Tchou, Michael J., M.D.
title	Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
title_short	Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
title_full	Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
title_fullStr	Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
title_full_unstemmed	Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions
title_sort	patterns of electrolyte testing utilization at children’s hospitals for common inpatient conditions
publisher	University of Cincinnati / OhioLINK
publishDate	2018
url	http://rave.ohiolink.edu/etdc/view?acc_num=ucin1543839434925304
work_keys_str_mv	AT tchoumichaeljmd patternsofelectrolytetestingutilizationatchildrenshospitalsforcommoninpatientconditions
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Patterns of Electrolyte Testing Utilization at Children’s Hospitals for Common Inpatient Conditions

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