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Lab Test Utilization

Laboratory testing affects persons in every stage of life, and almost everyone will have numerous laboratory tests conducted during their lifetime. More than 4000 different laboratory tests are available today for clinical use, of which, approximately 500 are ordered on a daily basis. An estimated 7 to 10 billion laboratory tests are performed each year in the United States. Up to 85 percent of decisions about diagnosis and treatment are based on laboratory results. Laboratory test results comprise about 70 percent of the average patient's medical record. Laboratory charges comprise only 4% of care expenditures which equates to $60 billion per year. The rapid evolution of molecular diagnostics and whole genome sequence-based tests will lead to an even greater relative contribution laboratory testing to overall health care costs.

The most meaningful way to achieve savings is to focus on overall reductions in utilization rates for health care services and to eliminate the associated unnecessary capacity.

David H. Newman, author of Hippocrates’ Shadow, said “Doctors love tests, perhaps more than they love patients. It is how we are taught. EKGs, X-rays, MRIs, CAT scans, colonoscopies, blood tests, stress tests, cultures, you name it. We believe in the objectivity, utility and veracity of test results.”

In future blogs, I will attempt to define an inappropriate or unnecessary test, determine the extent of inappropriate laboratory testing, review the causes of test over-utilization, present published evidence of test overuse and describe successful and unsuccessful campaigns to curb overuse.

Stay tuned!

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