A quasi-experimental study for inappropriate laboratory utilization from a payer perspective in Cyprus

ObjectiveLaboratory tests have progressively acquired a dominant role in screening, diagnosis, disease monitoring and outcome assessment. This trend has also adversely led to the inappropriate ordering of laboratory tests, the results of which are highly unlikely to establish or change diagnosis, and, in extent, influence the treatment decision-making of a specific disease. This practice raises the cost of healthcare while it exposes patients to unjustified risk as healthcare professionals may be led to perform unnecessary procedures. Study DesignA quasi-experimental study in the form of an interrupted time series analysis was performed to assess the potential impact of introduction of co-payment on cholesterol test ordering. MethodsThis study was performed using public health care sector data from Nicosia General Hospital and Nicosia primary health care centers. Daily ordering for all outpatient cholesterol tests were tracked for 43 consecutive months; 33 months prior to, and 10 months after the introduction of this measure. ResultsCo-payment resulted in an instant and significant reduction in cholesterol test ordering. The measure's impact remained unchanged throughout the observation period. ConclusionCo-payment can be considered to be a potent and durable measure to successfully contain inappropriate laboratory ordering. However, the long–term effect of this measure must be assessed to ensure that co-payment does not exert a negative effect on public health.