More laboratory tests performed at major teaching hospitals

(HealthDay)—For inpatients with a primary diagnosis of bacterial pneumonia or cellulitis, significantly more laboratory tests are performed per day at major teaching hospitals versus nonteaching hospitals, according to a study published online Nov. 13 in JAMA Internal Medicine.

Victoria Valencia, M.P.H., from Dell Medical School at The University of Texas at Austin, and colleagues quantified the differences in the use of laboratory tests between teaching and nonteaching hospitals using data for 24,118 adult inpatients with a primary diagnosis of bacterial pneumonia and 19,211 with a primary diagnosis of cellulitis at hospitals across Texas.

The researchers found that there was significant variation in the mean number of laboratory tests per day by hospital type, with major teaching hospitals having the highest number for both bacterial pneumonia (13.21 versus 8.92 at major teaching hospitals and nonteaching hospitals, respectively) and cellulitis (10.43 versus 7.29 at major teaching hospitals versus nonteaching hospitals, respectively). For both conditions, this association persisted for all levels of illness severity, except for patients with cellulitis at the highest illness severity level. There was a significant difference in the marginal effect of hospital teaching status on the mean number of laboratory tests per day between major teaching and nonteaching hospitals after the researchers controlled for additional patient and encounter covariates (difference, 3.58 and 2.61 for bacterial pneumonia and cellulitis, respectively).

"These results support the need to examine how the culture of training environments may contribute to increased use of laboratory tests," the authors write.

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