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Changes in Test Volumes During Coronavirus Disease 2019 (COVID-19): A Laboratory Stewardship Opportunity.
Singh, Ila R; Dowlin, Michael; Chong, Thomas H; Nakamoto, Jon M; Hilborne, Lee H.
  • Singh IR; From the Department of Pathology and Immunology, Baylor College of Medicine, Texas Children's Hospital, Houston (Singh, Dowlin, Chong).
  • Dowlin M; From the Department of Pathology and Immunology, Baylor College of Medicine, Texas Children's Hospital, Houston (Singh, Dowlin, Chong).
  • Chong TH; From the Department of Pathology and Immunology, Baylor College of Medicine, Texas Children's Hospital, Houston (Singh, Dowlin, Chong).
  • Nakamoto JM; Amazon.com, Inc, Seattle, Washington (Nakamoto).
  • Hilborne LH; the Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California (Hilborne).
Arch Pathol Lab Med ; 145(7): 821-824, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1339693
ABSTRACT
CONTEXT.­ Coronavirus disease 2019 (COVID-19) changed the dynamics of health care delivery, shifting patient priorities and deferring care perceived as less urgent. Delayed or eliminated care may place patients at risk for adverse outcomes. OBJECTIVE.­ To identify opportunities for laboratory test stewardship to close potential gaps in care created by the COVID-19 pandemic. DESIGN.­ The study was a retrospective time series design examining laboratory services received before and during the COVID-19 pandemic at a large metropolitan health system serving women and children. RESULTS.­ Laboratory test volumes displayed 3 distinct patterns (1) a decrease during state lockdown, followed by near-complete or complete recovery; (2) no change; and (3) a persistent decrease. Tests that diagnose or monitor chronic illness recovered only partially. For example, hemoglobin A1c initially declined 80% (from 2232 for April 2019 to 452 for April 2020), and there was a sustained 16% drop (28-day daily average 117 at August 30, 2019, to 98 at August 30, 2020) 4 months later. Blood lead dropped 39% (from 2158 for April 2019 to 1314 for April 2020) and remained 23% lower after 4 months. CONCLUSIONS.­ The pandemic has taken a toll on patients, practitioners, and health systems. Laboratory professionals have access to data that can provide insight into clinical practice and identify pandemic-related gaps in care. During the pandemic, the biggest patient threat is underuse, particularly among tests to manage chronic diseases and for traditionally underserved communities and people of color. A laboratory stewardship program, focused on peri-pandemic care, positions pathologists and other laboratory professionals as health care leaders with a commitment to appropriate, equitable, and efficient care.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Care Rationing / Diagnostic Tests, Routine / Clinical Laboratory Services / COVID-19 / Health Services Accessibility Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Arch Pathol Lab Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Care Rationing / Diagnostic Tests, Routine / Clinical Laboratory Services / COVID-19 / Health Services Accessibility Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: Arch Pathol Lab Med Year: 2021 Document Type: Article