This article is more than 5 years old. Information may no longer be current.
Judicious C. difficile sampling reduces cost burden of overtesting
Click Here to Manage Email Alerts
Automatic rejection of nondiarrheal samples submitted for Clostridium difficile infection testing significantly reduced patient and hospital costs related to overtesting, according to recent research in Hospital Pediatrics.
“Our study highlights the need for judicious pediatric Clostridium difficile infection testing and thus treatment according to published guidelines and standards,” J. Michael Klatte, MD, assistant professor of the department of pediatrics at Tufts University School of Medicine, and colleague wrote. “Reducing overuse of C. difficile infection testing has the potential to improve patient care by reducing unnecessary antibiotic exposure in patients with a positive test who do not have symptoms consistent with C. difficile infection.”
The researchers developed an initiative that included multiple provider education methods, computerized order entry modifications and an automatic declination system for laboratory testing requests of samples at a children’s hospital in Missouri. Samples from children aged 1 year or younger were automatically rejected if they were nondiarrheal in consistency, as recommended by the AAP and the Infectious Diseases Society of America. The researchers also calculated the effect of this initiative on submissions of nondiarrheal specimens during a 12-month period. Cost savings were analyzed at the conclusion of the study period.
Study results showed that the percentage of samples tested after submission dropped to an average of 53.8% compared with 100% before the intervention. Despite an initial dip in sample submissions, the researchers wrote, over time biweekly test-ordering practices were unaffected by the initiative.
By automatically declining the laboratory testing of nondiarrheal specimens (n = 217), the initiative reduced hospital testing-related costs by approximately $3,600, while unadjusted patient savings were estimated at $32,000, according to the study.
“This [study] is a good example of financial stewardship in this era in which reduction of unnecessary costs and patient charges are becoming increasingly important,” Klatte and colleagues wrote. “This study also underscores the importance of active, ongoing collaboration between physicians and microbiology laboratory professionals and the necessity of this partnership for timely institution of hospital policies pertaining to infectious diseases.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts