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Residents Often Order Perceived Unnecessary Lab Tests

Behaviors attributed to health system culture, lack of transparency about health care service costs

WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Residents frequently order perceived unnecessary inpatient laboratory tests, according to a study published online Aug. 13 in the Journal of Hospital Medicine.

Mina S. Sedrak, M.D., from the City of Hope in Duarte, Calif., and colleagues conducted a qualitative analysis of internal medicine (IM) and general surgery (GS) residents at a large academic center, and describe the frequency of perceived unnecessary ordering of inpatient laboratory tests and factors contributing to that behavior. The sample included 57.0 and 54.4 percent of IM and GS residents, respectively.

The researchers found that 88.2 and 67.7 percent of IM and GS residents, respectively, reported perceived unnecessary inpatient laboratory test ordering, which occurred on a daily basis for 43.5 and 32.3 percent of IM and GS residents, respectively. Residents attributed their behaviors to the culture of the health system, lack of transparency of health care service-associated costs, and lack of faculty role models that encourage restraint.

“Our findings offer a rich understanding of residents’ beliefs about their own role in unnecessary lab ordering and explore possible solutions through the lens of the resident,” the authors write. “It is unclear whether tests deemed ‘unnecessary’ by residents would also be considered unnecessary by attending physicians or even patients. Future efforts are needed to better define which inpatient tests are unnecessary from multiple perspectives, including clinicians and patients.”

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