ArticleJournal of general internal medicine2018
Impact of Cost Display on Ordering Patterns for Hospital Laboratory and Imaging Services.
Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Electronic health record intervention to increase use of NSAIDs as analgesia for hospitalised patients: a cluster randomised controlled study.BMJ health & care informatics · 2023Trial
- A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: A randomized controlled trial.Journal of hospital medicine · 2023Trial
- Does an electronic pathology ordering system change the volume and pattern of routine testing in hospital? An interrupted time series analysis.Journal of clinical pathology · 2024Article
- Testing wisely: toward more efficient laboratory utilization.Proceedings (Baylor University. Medical Center) · 2024Article
- Article
- Engaging Frontline Physicians in Value Improvement: A Qualitative Evaluation of Physician-Directed Reinvestment.Journal of healthcare leadership · 2022Article
- Effect of a price display intervention on laboratory test ordering behavior of general practitioners.BMC family practice · 2021Article
- Laboratory Demand Management Strategies-An Overview.Diagnostics (Basel, Switzerland) · 2021Review
- Capsule Commentary on Silvestri et al., Impact of Cost Display on Ordering Patterns for Hospital Laboratory and Imaging Services.Journal of general internal medicine · 2018Article
- The role of a best practice alert in the electronic medical record in reducing repetitive lab tests.ClinicoEconomics and outcomes research : CEOR · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundPhysicians "purchase" many health care services on behalf of patients yet remain largely unaware of the costs of these services. Electronic health record (EHR) cost displays may facilitate cost-conscious ordering of health services.
objectiveTo determine whether displaying hospital lab and imaging order costs is associated with changes in the number and costs of orders placed.
designQuasi-experimental study.
participantsAll patients with inpatient or observation encounters across a multi-site health system from April 2013 to October 2015.
interventionDisplay of order costs, based on Medicare fee schedules, in the EHR for 1032 lab tests and 1329 imaging tests. MAIN MEASURES: Outcomes for both lab and imaging orders were (1) whether an order was placed during a hospital encounter, (2) whether an order was placed on a given patient-day, (3) number of orders placed per patient-day, and (4) cost of orders placed per patient-day. KEY
resultsDuring the lab and imaging study periods, there were 248,214 and 258,267 encounters, respectively. Cost display implementation was associated with a decreased odds of any lab or imaging being ordered during the encounter (lab adjusted odds ratio [AOR] = 0.97, p = .01; imaging AOR = 0.97, p < .001), a decreased odds of any lab or imaging being ordered on a given patient-day (lab AOR = 0.95, p < .001; imaging AOR = 0.97, p < .001), a decreased number of lab or imaging orders on patient-days with orders (lab adjusted count ratio = 0.93, p < .001; imaging adjusted count ratio = 0.98, p < .001), and a decreased cost of lab orders and increased cost of imaging orders on patient-days with orders (lab adjusted cost ratio = 0.93, p < .001; imaging adjusted cost ratio = 1.02, p = .003). Overall, the intervention was associated with an 8.5 and 1.7% reduction in lab and imaging costs per patient-day, respectively.
conclusionsDisplaying costs within EHR ordering screens was associated with decreases in the number and costs of lab and imaging orders.
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