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  • Title: Cost per Case Mix Index-Adjusted Hospital Day as a Measure of Effective Laboratory Utilization Efforts in a Growing Academic Medical Center.
    Author: Behling KC, Bierl C.
    Journal: Am J Clin Pathol; 2019 Mar 01; 151(4):371-376. PubMed ID: 30423021.
    Abstract:
    OBJECTIVES: Traditional laboratory utilization measures are unable to detect the results of small-scale utilization improvement efforts in a background of rising patient volumes and acuity. However, accurate assessment is necessary to document effectiveness of these efforts. METHODS: Test menu changes, physician education, and laboratory utilization feedback were used to address costs and overused tests. Effectiveness was evaluated using cost/case mix index (CMI)-adjusted hospital day and inpatient tests/CMI-adjusted discharge. These metrics were compared with the more traditional measures of cost/test and inpatient tests/discharge. RESULTS: Cost/CMI-adjusted hospital day and inpatient tests/CMI-adjusted discharge better demonstrated the impact of utilization improvement efforts compared with more traditional measures because they account for changes in patient volume and acuity. CONCLUSIONS: Cost/CMI-adjusted hospital day and tests/CMI-adjusted discharge show the effectiveness of laboratory utilization efforts despite increasing patient volume and acuity.
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