An audit of repeat testing at an academic medical center: consistency of order patterns with recommendations and potential cost savings

We aimed to evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility. For the target tests, we evaluated all inpatient test orders during 2016 for PURT by comparing the inter-test times to the maximum frequency indicated by guidance in the literature. Potential cost savings were calculated using the Centers for Medicare and Medicaid Services maximum allowable reimbursement rate. We evaluated result positivity as a determinant of PURT through logistic regression. Of the evaluated 4242 repeated target tests, 1854 (44%) were identified as PURT, representing an estimated cost savings opportunity of $37 830. Collectively, the association of result positivity and PURT was statistically significant (relative risk, 1.2; 95% CI, 1.1-1.3; P = 0.00). PURT contributes to unnecessary healthcare costs. We found that a small percentage of providers account for the majority of PURT, and PURT is associated with result positivity.