Surgical Vampires and Rising Health Care Expenditure

Abstract

The use of laboratory tests has been rapidly increasing over the past few decades to the point where phlebotomy is a substantial proportion of hospital expenditure, and much of it is unwarranted.¹ Many institutions have implemented interventions to reduce the amount of laboratory tests per patient. Interventions with significant results have been to (1) modify computerized ordering systems to limit options (T. Rosenbloom, MD, MPH, Department of Biomedical Informatics, Vanderbilt University, written communication, March 2007), (2) not allow tests to be ordered on a recurring basis, necessitating daily reevaluation,² (3) install pop-up reminders of what seem to be redundant tests,³ (4) require clerical justification for each test ordered by the ordering physician,⁴ and (5) unbundle tests so each specific value must be ordered separately (T. Rosenbloom, MD, MPH, Department of Biomedical Informatics, Vanderbilt University, written communication, March 2007).^5,6