Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study
Abstract Background Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review...
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BMC Health Services Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3181-z |
| _version_ | 1819078204357345280 |
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| author | Mei-Sing Ong Farah Magrabi Enrico Coiera |
| author_facet | Mei-Sing Ong Farah Magrabi Enrico Coiera |
| author_sort | Mei-Sing Ong |
| collection | DOAJ |
| description | Abstract Background Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. Methods A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients’ age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. Results Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. Conclusions Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization. |
| first_indexed | 2024-12-21T19:09:23Z |
| format | Article |
| id | doaj.art-ac1c33e8c6504e25a03943a5b6da9cd3 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-21T19:09:23Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-ac1c33e8c6504e25a03943a5b6da9cd32022-12-21T18:53:14ZengBMCBMC Health Services Research1472-69632018-05-011811810.1186/s12913-018-3181-zDelay in reviewing test results prolongs hospital length of stay: a retrospective cohort studyMei-Sing Ong0Farah Magrabi1Enrico Coiera2Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care InstituteAustralian Institute of Health Innovation, Macquarie UniversityAustralian Institute of Health Innovation, Macquarie UniversityAbstract Background Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. Methods A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients’ age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. Results Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. Conclusions Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.http://link.springer.com/article/10.1186/s12913-018-3181-zLength of stayTest resultsDelay |
| spellingShingle | Mei-Sing Ong Farah Magrabi Enrico Coiera Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study BMC Health Services Research Length of stay Test results Delay |
| title | Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study |
| title_full | Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study |
| title_fullStr | Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study |
| title_full_unstemmed | Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study |
| title_short | Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study |
| title_sort | delay in reviewing test results prolongs hospital length of stay a retrospective cohort study |
| topic | Length of stay Test results Delay |
| url | http://link.springer.com/article/10.1186/s12913-018-3181-z |
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