Spending with unnecessary complementary tests for hypertension and diabetes in health services

Abstract

The aims of this study were to analyze unnecessary laboratory exams for patients with hypertension and diabetes and to check the expenditures involved. This is an exploratory-descriptive, cross-sectional study with a quantitative approach. We used data from medical records of 293 patients registered in primary units - the Family Health Center (NSF3); secondary: School Health Center (CSE); and tertiary: Hospital das Clínicas (HC) from 2006 to 2009 in a city in Southeastern Brazil. We identified a total of 9,522 laboratory tests, of which 5.97% were unnecessary. Of these, about 58% were requested by NSF3 and 42% by CSE. Results suggest there is a lack of integration among different levels of health care, which result in misallocation of resources and unnecessary spending.

What methods are being used to create an evidence base on the use of laboratory tests to monitor long-term conditions in primary care? A scoping review

“…1 ) ( 8 , 18–109 ), including seven studies for which full texts could not be retrieved, so data were abstracted from the abstract ( 101 , 102 , 104 , 106–109 ). Six included non-English papers were in French, German, Hebrew, Hungarian, Polish and Portuguese, which were translated and assessed by the review team ( 34 , 40 , 110–113 ).…”

“…The most common aim was ‘how does monitoring vary’ ( n = 38), in which studies described the variation in monitoring between regions, patient subgroups or over time. Three studies investigated the costs of over-testing, but none of the studies reported on the possible harms of over-testing to patients ( 34 , 78 , 105 ).…”

“…Thirteen studies (14%) reported patient outcomes ( 18 , 19 , 22 , 30 , 60 , 70 , 71 , 82 , 84 , 90 , 93 , 103 , 115 ), such as disease progression or incidence of complications. Seven studies (7%) reported costs as the outcome ( 34 , 52 , 76 , 78 , 92 , 99 , 105 ), such as cost-effectiveness of a screening program for certain patient subgroups. Two studies investigated the response to test results ( 51 , 72 ), i.e.…”

Anais Do I Congresso Luso-Brasileiro De Saúde Coletiva (On-Line) – Resumos Expandidos

“…"Exames de rotina" em pacientes, a priori sem comorbidades, são grande parte das consultas em atenção básica (LANDSBERG, 2012). Eles geram altos custos em níveis de saúde pública, não se traduzem em melhoria de prevenção doenças e são motivos de transtorno ao paciente e ao médico (ARENA, 2014;TOSCAS, 2015;CAPILHEIRA, 2006).…”