Impact of providing fee data on laboratory test ordering: a controlled clinical trial.

摘要: Importance Inpatient care providers often order laboratory tests without any appreciation for the costs of tests. Objective To determine whether we could decrease number ordered by presenting with test fees at time entry in a tertiary hospital, adding extra steps to ordering process. Design Controlled clinical trial. Setting Tertiary hospital. Participants All providers, including physicians and nonphysicians, who through computerized provider system The Johns Hopkins Hospital. Intervention We randomly assigned 61 diagnostic an “active” arm (fee displayed) or control not displayed). During 6-month baseline period (November 10, 2008, May 9, 2009), did display fee data. intervention 1 year later 2009, 2010), displayed fees, based on Medicare allowable fee, active only. Main Outcome Measures examined changes total orders placed, frequency (per patient-day), charges associated according (baseline vs period) study group (active control). Results For tests, rates were reduced from 3.72 per patient-day 3.40 (8.59% decrease; 95% CI, −8.99% −8.19%). increased 1.15 1.22 (5.64% increase; 4.90% 6.39%) (P  Conclusions Relevance Presenting data resulted modest ordering. Adoption this may reduce inappropriately