Assessment of the Effects of Reimbursement Policy on the Utilization of Clinical Laboratory Testing and the Contribution of Testing to Patient Care (Outcomes and Risk Factors in Physician Office Clinical Laboratory Testing for Prothrombin Time (Protime) and Digoxin)

摘要

The goal of the report is to determine the feasibility of using claims data to identify errors in laboratory testing. Both physician office labs and independent clinical laboratories were examined. The project assessed the results of two tests: the prothrombin time (PT) or protime test measures the time required for blood to clot and the digoxin test monitors the blood level of digoxin, a drug that improves cardiac output. The authors first developed a model to predict the risk of adverse outcomes following these tests and then examined actual adverse outcomes using samples of 14,755 PT tests and 30,685 digoxin tests drawn from Medicare claims processed in six states. The report concludes that the approach can be used to identify labs that may be making systematic errors and to encourage corrective action.