Repeat haematinic requests in patients with previous normal results: the scale of the problem in elderly patients at a district general hospital

Int J Lab Hematol. 2011 Dec;33(6):610-3. doi: 10.1111/j.1751-553X.2011.01350.x. Epub 2011 Jun 22.

Abstract

Repeating normal laboratory tests can waste resources. This study aimed to quantify unnecessary repeat haematinic tests taken from the elderly in a district general hospital. Haematinic tests (ferritin, B12, serum folate) from patients age ≥ 70 years were reviewed for repeat tests during an 8-week period. Questionnaires were given to doctors to establish when the considered repeating a 'borderline low normal' result to be clinically justifiable. 7.7% of all haematinic tests were repeat tests and of these, the majority (83%) was performed following a previously normal result. Thirteen of 24 doctors believed repeating a normal result at the bottom of the normal range ('borderline low normal') was justifiable. After excluding 'borderline low normal' results, 6.0% (at minimum) of repeat tests were done following a previous normal result and were unnecessary. This audit showed that there are a significant number of unnecessary repeat haematinic tests being performed.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Female
  • Ferritins / blood*
  • Folic Acid / blood*
  • Hematologic Tests / methods*
  • Hematologic Tests / standards
  • Hematologic Tests / statistics & numerical data
  • Hospitals, General / economics
  • Humans
  • Male
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends
  • Reference Values
  • Surveys and Questionnaires
  • Vitamin B 12 / blood*

Substances

  • Ferritins
  • Folic Acid
  • Vitamin B 12