Tests performed on day of discharge represent 6.8 percent of all tests, 46.8 percent of missed results
Poor follow-up of test results at or after discharge from the hospital is often due to tests requested on the day of discharge, according to a letter to the editor published online Aug. 13 in the Archives of Internal Medicine.
Noting that tests ordered on the day of discharge have a very limited chance of being reviewed, Mei-Sing Ong, Ph.D., from the University of New South Wales in Sydney, Australia, and colleagues assessed the prevalence of missed follow-up of laboratory tests performed between February and June 2011 in a 370-bed metropolitan teaching hospital. The prevalence was calculated as the proportion of tests that were not reviewed at patient discharge or at two months after discharge.
The researchers found that 3.1 percent of the 662,858 individual tests were not reviewed at discharge, and 1.5 percent were not reviewed at two months after discharge. Tests that were performed on the day of discharge represented 6.8 percent of all tests, but accounted for 46.8 percent of all missed results measured at discharge and 41.1 percent of those measured two months later. The risk of missed follow-up was significantly increased for tests ordered on the day of discharge versus other days (21.3 versus 1.8 percent; odds ratio, 10.8); this disparity persisted at two months following discharge. The rate of review increased with duration of test result availability during admission.
"It appears that at least some late admission tests represent an opportunity to optimize test ordering," the authors write. "Tests ordered as a result of poor discharge planning may well be unnecessary and are therefore strong candidates for targeted intervention."
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