Laboratory testing is an important component of diagnosis and management of chronic diseases. Similar to other medical interventions, laboratory studies contribute to rising healthcare costs. There is increased focus on laboratory expenditures and suggestions that over-utilization may reflect suboptimal chronic disease management. Individuals with inflammatory bowel disease require periodic, and occasionally frequent, laboratory testing. There is limited data assessing the amount of labs performed during the course inflammatory bowel disease. This study evaluated the amount of laboratory testing by gastroenterologists in individuals with inflammatory bowel disease at the time of diagnosis compared to later in the course of the disease. A medical record review of inflammatory bowel disease patients at a university medical center during an 18-month period was performed. Patients in whom the date of diagnosis was unknown were excluded. Patient age, gender, disease type, date of diagnosis, and outpatient labs by gastroenterologists were obtained. The amount of labs ordered during the study period in individuals diagnosed within 0–6 months and in those with a diagnosis >6 months, in individuals diagnosed within 0–18 months and in those with a diagnosis >18 months, and in individuals diagnosed within 0–30 months and in those with a diagnosis >30 months were compared. A database, maintaining patient confidentiality, was created. Statistical analysis was performed using unpaired T testing, with statistical significance set at P < 0.05. The study was approved by the university institutional review board. Two hundred ninety-five medical records (174 women, 121 men; mean age of 41.1 years) were reviewed. One hundred sixty patients had Crohn’s disease, 133 ulcerative colitis and 2 with indeterminate colitis. The average disease duration was 12.37 years. During the study period, the number of labs performed 0–6 months following diagnosis were significantly less than the number of labs performed in individuals with a diagnosis >6 months (3.84 versus 8.91, P = 0.019). There was no significant difference in the number of labs performed in individuals 0–18 months following diagnosis compared to individuals with a diagnosis >18 months (7.24 versus 8.75, P = 0.39). Additionally, there was no significant difference in the number of labs performed in individuals 0–30 months following diagnosis compared to individuals with a diagnosis >30 months (8.83 versus 8.39, P = 0.83). Individuals with chronic diseases, including inflammatory bowel disease, have more health care encounters and laboratory testing than others. Few studies have compared the amount of laboratory testing in inflammatory bowel disease at the time of diagnosis and later in the course of the disease. This study revealed that during an 18-month period, there were less labs obtained in individuals who were diagnosed within 0–6 months compared to individuals who had been diagnosed for >6 months. Increased labs later in the course of disease likely reflect the monitoring necessary for health maintenance, during exacerbations and for medication stabilization. As the focus on health care costs continues, it is important that there is recognition that laboratory testing in inflammatory bowel disease may not be a reflection of excess health care expenditure, but necessary to ensure optimal management.
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Oct 6, 2023
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Open Access