Request of laboratory liver tests in primary care in Spain
| Autor: | Javier Martin Oncina, MARIA SALINAS, ANTONIO BUÑO SOTO, Emilio Flores, Maite Lopez-Garrigos, MARIA ISABEL LLOVET LOMBARTE, Marcos López-Hoyos |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Pathology Population Psychological intervention Primary care Liver tests Liver disease Liver Function Tests Humans Medicine Alanine aminotransferase education Retrospective Studies education.field_of_study Primary Health Care Hepatology medicine.diagnostic_test Clinical Laboratory Techniques business.industry Liver Diseases Gastroenterology Retrospective cohort study medicine.disease Spain Emergency medicine Costs and Cost Analysis Laboratories business Liver function tests |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 27:1130-1136 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/meg.0000000000000427 |
| Popis: | Aims Liver laboratory tests are used to screen for liver disease, suggest the underlying cause, estimate the severity, assess prognosis, and monitor the efficacy of therapy. The aim of this study was to compare the liver laboratory tests requesting patterns by GPs in Spain, according to geographic and hospital characteristics, to investigate the degree of requesting appropriateness. Materials and methods One hundred and forty-one clinical laboratories were invited to participate from diverse regions across Spain. They filed out the number of laboratory liver tests requested by GPs for the year 2012. Two types of appropriateness indicators were calculated: every test request per 1000 inhabitants or ratios of related tests requests. The indicator results obtained were compared between the different hospitals, according to their setting, location, and management. The savings generated, if each area would have achieved indicator targets, were calculated. Results We recruited 76 laboratories covering a population of 17,679,195 inhabitants. GPs requested 20,916,780 laboratory liver tests in the year 2012. No differences were obtained according to their setting. Lactate dehydrogenase and direct bilirubin per 1000 inhabitants were significantly higher in institutions with private management. Largest differences were observed between communities. Nine, 31, 0, and 13 laboratories, respectively, achieved the aspartate aminotransferase, lactate dehydrogenase, γ-glutamyl transpeptidase, and total bilirubin-related alanine aminotransferase indicator targets. Reaching ratios would have resulted in savings of €1,028,468. Conclusion There was a high variability in the request of liver tests. This emphasizes the need to implement interventions to improve appropriate use of liver tests. |
| Databáze: | OpenAIRE |
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