Bir Üniversite Hastanesinde Gereksiz Laboratuvar Test İstemlerinin İncelenmesi

Abstract

All healthcare budgets around the world are under intense pressure to eliminate inefficiencies in the system and reduce costs, while having to ensure quality and patient safety. Studies have shown that unnecessary use of laboratory tests has an undeniable effect on unnecessary healthcare costs. Unnecessary use of laboratory tests is when physicians, who are affected by various factors, consciously or unconsciously request tests that will not affect the course of the disease. The aim of the study is to determine the usage levels of the 15 most frequently requested biochemistry laboratory tests and to reveal the reasons behind the unnecessary test order habits of physicians. In the study, a retrospective analysis of laboratory usage data was carried out according to the minimum time between two tests in order to determine the unnecessary test request levels, in order to identify possible factors that lead to unnecessary use of physicians, a questionnaire was developed as a data collection tool and validity and reliability studies were conducted and applied on 179 physicians. As a result of the analysis, the unnecessary usage rate of 15 biochemistry tests in the 18-month period was found to be 9.1%, while the cost of using unnecessary laboratory tests was 584.186,3 TL. It has been observed that the most unnecessary test requests are made by internal branches and mostly by departments of Internal Medicine; In addition, the physicians whose are most likely to request unnecessary tests consist of specialist physicians and female physicians. It has been observed that the tests requested for male patients are more likely to be unnecessary, and as the age of the patients increases, the probability of unnecessary tests increases. When the reasons affecting the physicians' unnecessary laboratory test usage behaviors are investigated; It has been observed that the past bad experiences of physicians, routine test requests, difficulties in reaching the tests applied to the patient before, and the comfort area provided by the patient's social security to the physician and patient are the unnecessary reasons for unnecessary use; aditionaly it has been observed that physicians' gender, title, branch, institutional and professional experience periods and their malpractice experience have an effect on unnecessary test requests. It is believed that the results of this study, which examines the determinants of unnecessary test use and the opinions of physicians on the possible causes of unnecessary test use, will provide important information to decision-makers in determining the priority steps to be taken to prevent unnecessary tests and the improvements to be made.