307 Clinical Laboratory Test Utilization by Hospital Category Across 741 US Hospitals

Introduction/Objective Laboratory test utilization for patients for a single diagnostic group likely differs between hospital types. Methods/Case Report Using the Vizient Clinical Data Base™, we compared laboratory utilization between five Vizient-defined US hospital cohorts categorized by hospital size and complexity of care (741 hospitals). We examined hospitalizations (N = 1,154,775) for four Medicare severity-adjusted diagnosis related groups (MSDRGs): sepsis, heart failure, renal failure, and gastrointestinal hemorrhage, each stratified by severity of disease (SOD), over one year (2022). We looked at aggregate clinical laboratory tests as well as specific CBC and CMP tests. Results Mean laboratory test utilization per hospitalization was highest for comprehensive academic hospitals and lowest (29%-68% lower) for critical access and small hospitals within all 4 MSDRG triplets. Comparisons by laboratory tests per hospital day revealed a similar, albeit somewhat less pronounced, pattern. Furthermore, comparing test resource intensity weights, rather than test counts, demonstrated similar differences. CBC testing followed the same pattern as aggregate laboratory tests while CMP testing tended to be higher for smaller hospitals in the non-sepsis MSDRGs. Higher severity SOD levels within each MSDRG tended to have greater differences in utilization Conclusion Overall, hospital cohorts of larger size and primary academic teaching status had higher test utilization for each severity-adjusted MSDRG.