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Cited by 22Clinical Laboratory Practices and Quality ControlHealthcare cost, quality, practicesHealthcare Operations and Scheduling Optimization

Delay in reviewing test results prolongs hospital length of stay: a retrospective cohort study

Open access
Ong, Mei-Sing, Magrabi, Farah, Coiera, Enrico·2018·BMC Health Services Research
DOI 10.1186/s12913-018-3181-zPMC PMC5956538
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Abstract

BACKGROUND: Failure in the timely follow-up of test results has been widely documented, contributing to delayed medical care. Yet, the impact of delay in reviewing test results on hospital length of stay (LOS) has not been studied. We examine the relationship between laboratory tests review time and hospital LOS. METHODS: A retrospective cohort study of inpatients admitted to a metropolitan teaching hospital in Sydney, Australia, between 2011 and 2012 (n = 5804). Generalized linear models were developed to examine the relationship between hospital LOS and cumulative clinician read time (CRT), defined as the time taken by clinicians to review laboratory test results performed during an inpatient stay after they were reported in the computerized test reporting system. The models were adjusted for patients' age, sex, and disease severity (measured by the Charlson Comorbidity index), the number of test panels performed, the number of unreviewed tests pre-discharge, and the cumulative laboratory turnaround time (LTAT) of tests performed during an inpatient stay. RESULTS: Cumulative CRT is significantly associated with prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of prolonged LOS by 13.2% (p < 0.0001). Restricting the analysis to tests with abnormal results strengthened the relationship between cumulative CRT and prolonged LOS, with each day of delay in reviewing test results increasing the likelihood of delayed discharge by 33.6% (p < 0.0001). Increasing age, disease severity and total number of tests were also significantly associated with prolonged LOS. Increasing number of unreviewed tests was negatively associated with prolonged LOS. CONCLUSIONS: Reducing unnecessary hospital LOS has become a critical health policy goal as healthcare costs escalate. Preventing delay in reviewing test results represents an important opportunity to address potentially avoidable hospital stays and unnecessary resource utilization.

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  • Late morning to early afternoon tends to be the busiest time, and the congestion often leads to longer turnaround times, especially when insufficient staffing exists.

    “However, late morning to early afternoon tends to be the busiest time, and the congestion often leads to longer turnaround times, especially when insufficient staffing exists [289].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [289]

    The Results (Clinical workflow; page not provided) show that test activity was concentrated from late morning into early afternoon and that turnaround times peaked around 2 pm. The Discussion says the high test load may have caused delays and suggests adding resources during peak periods, but it does not establish that insufficient staffing existed or that delays were especially long when staffing was insufficient. (LLM, conf=0.86)

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Research works printed but not linked: 1

  1. [1]Gonzalez JM National Health Care Expenses in the U.S. civilian noninstitutionalized population, 2011. MEPS statistical brief no. 425 2013 Rockville, MD Agency for Healthcare Research and Quality 29708697

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Related

Authors
Ong, M.-S., Magrabi, F., & Coiera, E.
Affiliations
  • Harvard University (US)
  • Macquarie University (AU)
Corresponding author
Ong, Mei-Sing
ORCID
Venue
BMC Health Services Research
Publisher
Springer Science and Business Media LLC
Published
2018-05-16
Volume
18
Issue
1
Pages
369-369
ISSN
1472-6963 (ISSN-L)
DOI
10.1186/s12913-018-3181-z
PMC
PMC5956538
OpenAlex
W2804396505
Cited by
22
References
19
Citations by year
2026: 3 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 1
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Health Services Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
Keywords
laboratory turnaround time, length of hospital stay, delayed discharge, laboratory abnormalities, inpatient care, healthcare resource utilization
MeSH terms
Adult, Aged, Diagnostic Tests, Routine, Female, Hospitals, Urban, Humans, Length of Stay, Male, Middle Aged, New South Wales, Patient Discharge, Retrospective Studies, Unnecessary Procedures, Delayed Diagnosis

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