308 Laboratory Test Utilization for Sepsis Patients Between >90 Large US Academic Hospitals

Introduction/Objective Laboratory test utilization variability among academic hospitals has been demonstrated. Methods/Case Report Using the Vizient Clinical Data Base™, we compared laboratory utilization within the Vizient-defined comprehensive academic hospital cohort (N = 105 hospitals) for patients in the sepsis Medicare severity-adjusted diagnosis related group (MSDRG), stratified into three severity of disease (SOD) levels over one year (2022). We examined aggregate clinical laboratory as well as specific CBC and CMP test utilization for a trimmed hospital list (5th to 95th percentile of laboratory tests per hospitalization) to mitigate outliers. Results Laboratory test utilization per hospitalization demonstrated considerable variability with a coefficient of variation (CV) of 35.5%, 26.0%, and 46.9%, for high, moderate, and low SOD levels, respectively. The ratio of the interquartile range to the median (IQR/median) demonstrated somewhat larger values. Laboratory tests per hospital variability measures revealed similar CV and IQR/median measurements. CBC test variability was somewhat smaller with CVs of 24.5%, 14.8%, and 14.4% for high, moderate, and low SOD levels. On the other hand, the variability in CMP testing was somewhat larger with CVs of 60.0%, 48.2%, and 46.1% for high to low SOD. Conclusion . There is marked variation in laboratory test utilization for patients in a single severity-adjusted diagnostic group among academic hospitals.