How to save costs by reducing unnecessary testing: Lean thinking in clinical practice

European Journal of Internal Medicine

Volumn 23, Issue 1, 2012, Pages 70-75

  Vegting, Irene L ^a   Van Beneden, Marlou ^a   Kramer, Mark H H ^a,b   Thijs, Abel ^a,b   Kostense, Piet J ^b   Nanayakkara, Prabath W B ^a,b  

^a VU UNIVERSITY AMSTERDAM   (Netherlands)

^b ACADEMIC MEDICAL CENTER   (Netherlands)

Author keywords

Awareness; Cost reduction; Diagnostic tests; Health care expenditure; Laboratory tests; Unnecessary testing

Indexed keywords

ARTICLE; CLINICAL PRACTICE; COST CONTROL; DIAGNOSTIC TEST; ECONOMIC EVALUATION; HEALTH CARE COST; HEALTH CARE QUALITY; LABORATORY TEST; OUTCOME ASSESSMENT;

COST SAVINGS; DIAGNOSTIC TESTS, ROUTINE; HUMANS; PILOT PROJECTS; UNNECESSARY PROCEDURES;

EID: 83555174287     PISSN: 09536205     EISSN: 18790828     Source Type: Journal    
DOI: 10.1016/j.ejim.2011.07.003     Document Type: Article

References (31)

1. A.E.M. de Hollander, N. Hoeymans, J.M. Melse, J.A.M. van Oers, J.J. Polder. Zorg voor gezondheid. Volksgezondheid, toekomst en verkenning 2006. Rijksinstituut voor volksgezondheid en milieu. RIVM-rapportnummer: 270061003.
2. OECD (2009), "Total expenditure on health," Health: Key Tables from OECD, No. 1.doi: 10.1787/20758480-2009-table1.
3. OECD (2011), "Total expenditure on health," Health: Key Tables from OECD, No. 1.doi: 10.1787/hlthxp-total-table-2011-1-en.
4. Health of nations Available from http://www.healthofnations.com/ countries/profile/netherlands
5. A. de Jong, and C. van Duin Regionale prognose 2009-2040: vergrijzing en omslag van groei naar krimp Planbureau voor de leefomgeving 2010 www.pbl.nl
6. A. Blokstra, W.M.M. Verschuren, C.A. Baan, H.C. Boshuizen, T.L. Feenstra, R.T. Hoogenveen, et al. Vergrijzing en toekomstige ziektelast; Prognose chronische ziektenprevalentie 2005-2025. RIVM rapport 260401004/2007.
7. G.H. Beastall The modernisation of pathology and laboratory medicine in the UK: networking into the future Clin Biochem Rev 29 2008 3 10
8. P. Leurquin, V. van Casteren, and J. de Maeseneer Use of blood tests in general practice: a collaborative study in eight European countries. Eurosentinal study group Br J Gen Pract 45 1995 21 25
9. C. van Walraven, and C.D. Naylor Do we know what inappropriate laboratory utilization is? A systematic review of laboratory clinical audits JAMA 280 1998 550 558 (Pubitemid 28377676)
10. H.E. Davies, C.G. Wathen, and F.V. Gleeson Risks of exposure to radiological imaging and how to minimise them. Clinical review BMJ 342 2011 589 593
11. M.C. Alonso-Cerezo, J.S. Martin, M.A. Garcia Montes, and V.M. de la Iglesia Appropriate utilization of clinical laboratory tests Clin Chem Lab Med 47 2009 1451 1465
12. A. Larsson, M. Palmer, Hultén, and N. Tryding Large differences in laboratory utilisation between hospitals in Sweden Clin Chem Lab Med 38 2000 383 389
13. P.M. Broughton, and D.J. Worthington Laboratories respond differently to the same clinical request Ann Clin Biochem 26 1989 119 121 (Pubitemid 19088185)
14. Nederlandse zorg autoriteit www.nza.nl
15. E.A. Stuebing, and T.J. Miner Surgical vampires and rising health care expenditure. Reducing the cost of daily phlebotomy Arch Surg 146 2011 524 527
16. T.W. Moloney, and D.E. Rogers Medical technology: a different view of the contentious debate over costs N Eng J Med 301 1979 1413 1419 (Pubitemid 10199235)
17. H.V. Fineberg, and L.A. Pearlman Low-cost medical practices Annu Rev Public Health 3 1982 225 248
18. S. Lewis, and J. Foreman Low-cost diagnostic technologies and clinical outcomes: the impact of inappropriate utilization Int J Technol Assess Health Care 13 1997 501 511 (Pubitemid 28016438)
19. M.A. van Wijk, J. van der Lei, M. Mosseveld, A.M. Bohnen, and J.H. van Bemmel Assessment of decision support for blood test ordering in primary care. A randomized trial Ann Intern Med 134 2001 274 281
20. F.G.R. Fowkes, R. Hall, J.H. Jones, M.F. Scanlon, G.H. Elder, and D.R. Hobbs Trial of strategy for reducing the use of laboratory tests Br Med J 292 1986 883 885 (Pubitemid 16133625)
21. R. Calderon-Margalit, S. Mor-Yosef, M. Mayer, B. Adler, and S.C. Shapira An administrative intervention to improve the utilization of laboratory tests within a university hospital Int J Qual Health Care 17 2005 243 248 (Pubitemid 40873069)
22. K.I. Marton, V. Tul, and H.C. Sox Jr. Modifying test-ordering behaviour in the outpatient medical clinic. A controlled trial of two educational interventions Arch Intern Med 145 1985 816 821 (Pubitemid 15033240)
23. J.O. Zaat, J.T. van Eijk, and H.A. Bonte Laboratory test form design influences test ordering by general practitioners in The Netherlands Med Care 30 1992 1989 1998
24. E.G. Neilson, K.B. Johnson, S.T. Rosenbloom, W.D. Dupont, D. Talbert, and D.A. Gluse The impact of peer management on test-ordering behaviour Ann Int Med 141 2004 196 204
25. W.J.H.M. Verstappen, T. van der Weijden, J. Sijbrandij, I. Smeele, J. Hermsen, and J. Grimshaw Effect of a practice based strategy on test ordering performance of primary care physicians: a randomized trial JAMA 289 2003 2407 2412 (Pubitemid 37430174)
26. D.H. Solomon, H. Hashimoto, L. Daltroy, and M.H. Liang Techniques to improve physicians' use of diagnostic tests. A new conceptual framework JAMA 280 1998 2020 2027
27. E.A. Bookhaker, R.E. Ward, J.E. Uman, and B.D. McCarthy Patient notification and follow-up of abnormal test results. A physician survey Arch Intern Med 12 1996 327 331 (Pubitemid 26058485)
28. M.L. DeKay, and D.A. Asch Is defensive use of diagnostic tests good for patients, or bad? Med Decis Making 18 1998 19 28 (Pubitemid 28041634)
29. S.L. Clark, J.L. Cunningham, A.A. Rabinstein, and E.F. Wijdicks Electrolyte orders in the neuroscience intensive care unit: worth the value or waste? Neurocrit Care 14 2011 216 221
30. European Diagnostic Manufactures Association (EDMA) The European In Vitro Diagnostic (IVD) Market in 2009. Press release 1 December 2010 Available from http://www.edma-ivd.be/fileadmin/upl-documents/Market-Estimates/ EDMA-2010-12-01-PR-EDMS-FINAL.pdf
31. A. Benedict Cosimi Modern day bloodletting. Is that laboratory test necessary? Arch Surg 146 2011 524 527