Abstract：
OBJECTIVE: Analysis of laboratory value often lacks assessment of the laboratory\'s impact on quality of care. In this study, we aimed to determine the impact of bringing a heparin-induced thrombocytopenia (HIT) antibody assay in-house on a quality metric-patient hospital length of stay (LOS)-and assess any associated cost savings.
METHODS: A retrospective review of patient visits with a HIT antibody assay over a 7-year period determined the mean LOS in send-out vs in-house HIT antibody assay cohorts as well as cohorts of positive and negative results. Our systemwide mean LOS and metrics of acuity were analyzed. We performed a financial analysis of estimated cost savings.
RESULTS: We found a mean LOS reduction of 3.97 days in the in-house cohort, with no evidence of a systemwide LOS decrease or a decline in patient acuity. This reduction was largely driven by a reduction in LOS among patients with a negative assay result. We found an estimated total cost savings of $3.9 million and an estimated mean savings per patient of $7,305, despite escalating health care costs over time.
CONCLUSIONS: We demonstrated a reduction in LOS following the introduction of an in-house HIT antibody assay that cannot be attributed to either systemwide initiatives or reduced patient acuity and was driven largely by patients with negative assays. This reduction was associated with significant estimated cost savings.
METHODS: A retrospective review of patient visits with a HIT antibody assay over a 7-year period determined the mean LOS in send-out vs in-house HIT antibody assay cohorts as well as cohorts of positive and negative results. Our systemwide mean LOS and metrics of acuity were analyzed. We performed a financial analysis of estimated cost savings.
RESULTS: We found a mean LOS reduction of 3.97 days in the in-house cohort, with no evidence of a systemwide LOS decrease or a decline in patient acuity. This reduction was largely driven by a reduction in LOS among patients with a negative assay result. We found an estimated total cost savings of $3.9 million and an estimated mean savings per patient of $7,305, despite escalating health care costs over time.
CONCLUSIONS: We demonstrated a reduction in LOS following the introduction of an in-house HIT antibody assay that cannot be attributed to either systemwide initiatives or reduced patient acuity and was driven largely by patients with negative assays. This reduction was associated with significant estimated cost savings.
摘要：
目的：对实验室价值的分析往往缺乏对实验室对护理质量影响的评估。在这项研究中,我们的目的是确定在内部进行肝素诱导的血小板减少症(HIT)抗体检测对患者住院时间(LOS)质量指标的影响,并评估任何相关的成本节约.
方法：对7年的HIT抗体检测患者就诊进行回顾性回顾，确定了送出的HIT抗体检测队列和内部HIT抗体检测队列以及阳性和阴性结果队列的平均LOS。我们的全系统平均LOS和敏锐度指标进行了分析。我们对估计的成本节约进行了财务分析。
结果：我们发现在内部队列中平均LOS减少了3.97天，没有证据表明全系统LOS降低或患者视力下降。这种减少很大程度上是由具有阴性测定结果的患者中LOS的减少驱动的。我们发现，尽管随着时间的推移，医疗保健费用不断上升，但估计总成本节省了390万美元，每位患者平均节省了7305美元。
结论：我们证明了在引入内部HIT抗体测定后LOS的降低，这不能归因于全系统计划或患者视力降低，并且主要由阴性测定的患者驱动。这种减少与估计的大量成本节省有关。
方法：对7年的HIT抗体检测患者就诊进行回顾性回顾，确定了送出的HIT抗体检测队列和内部HIT抗体检测队列以及阳性和阴性结果队列的平均LOS。我们的全系统平均LOS和敏锐度指标进行了分析。我们对估计的成本节约进行了财务分析。
结果：我们发现在内部队列中平均LOS减少了3.97天，没有证据表明全系统LOS降低或患者视力下降。这种减少很大程度上是由具有阴性测定结果的患者中LOS的减少驱动的。我们发现，尽管随着时间的推移，医疗保健费用不断上升，但估计总成本节省了390万美元，每位患者平均节省了7305美元。
结论：我们证明了在引入内部HIT抗体测定后LOS的降低，这不能归因于全系统计划或患者视力降低，并且主要由阴性测定的患者驱动。这种减少与估计的大量成本节省有关。
