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J Psychiatr Pract. 2011 Sep;17(5):375-81. doi: 10.1097/01.pra.0000405369.20538.84.

The utility and financial implications of obtaining routine laboratory screening upon admission for child and adolescent psychiatric inpatients.

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  • 1Pennsylvania State Milton S. Hershey Medical Center, Hershey, PA 17033, USA. Lfeldman@hmc.psu.edu

Abstract

The authors retrospectively explored the utility and fiscal implications of obtaining routine laboratory screening upon admission for child and adolescent psychiatric inpatients. A chart review of 153 sequential admissions (142 unique patients, with 11 patients admitted twice) over a recent 4-month period was conducted. Overall, 97.2% of all subjects who received a screening laboratory test had at least one abnormal finding. However, only four test results (<0.5%) actually had an impact on the psychiatric treatment plan or required immediate medical attention. With an average cost per patient for the full screening battery of $33-$122 and an average yearly direct cost to the inpatient unit of almost $38,000, potential alternatives to routine admission screenings are discussed. Given the cost of this relatively low yield outcome, these findings have important implications for psychiatric practice and cost-benefit analyses, which need to be further evaluated to better determine the actual utility of routine laboratory examinations upon admission.

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