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Cutting down on unnecessary lab tests.

As the cost of medical care continues to outpace the financial resources available to deliver care, routine medical procedures are being reviewed to determine their cost-effectiveness. If a procedure normally done on all patients in a particular situation proves to have limited value, then it should be used more selectively as individual circumstances dictate, rather than as an across-the-board routine.

One such routine has been a battery of preoperative laboratory tests on healthy patients undergoing elective surgery. The value of this practice was recently reviewed at the Mayo Clinic. The impact of the battery of tests regularly used on such patients was found to be extremely limited--of 3,782 patients routinely tested, only 160 (4.2 percent) showed significant abnormalities in their lab tests. None of these results caused a delay in the surgery, and action was taken in only five cases on the basis of the test results. In no case was the outcome of the surgery affected in any way by these abnormalities.

Because of these findings, the Mayo Clinic has eliminated most routine laboratory tests for healthy patients undergoing elective surgery. Instead, laboratory tests are selectively ordered only if the routine preoperative history and physical examination suggest that a particular lab test is needed.
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Publication:Medical Update
Date:May 1, 1991
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