Document Detail

Evaluation of a protocol to control utilization of B-type natriuretic peptide testing.
MedLine Citation:
PMID:  16891192     Owner:  NLM     Status:  MEDLINE    
The Veterans Affairs (VA) Boston Healthcare System, Boston, MA, instituted a protocol limiting the number of B-type natriuretic peptide (BNP) assays to 1 per hospitalization or outpatient visit and requiring approval of the cardiology service for more than 1 because of a 3-fold monthly increase in BNP testing. Effectiveness of this protocol was assessed by studying BNP utilization for 6-month periods before and after institution of the protocol. Before: 1,886 assays in 752 patients; mean BNP assays per patient, 2.5; direct reagent cost, $33,948; 1 BNP assay in 57.3% (431) of patients; 321 patients with multiple and 204 patients with serial BNP requests. After: 782 assays (-58.5%) in 593 patients (-21.1%); mean BNP assays per patient, 1.3 (-48.0%); direct reagent cost, $14,076 (-58.5%); 1 BNP assay in 81.1% (481) of patients; 112 patients with multiple and 24 patients with serial BNP requests (-88.2%). The emergency department was the source of BNP assays in 15.4% of requests before compared with 58.1% after introduction of the protocol. The protocol with slight modifications has been adopted by other VA medical centers in New England and may serve as a model for other medical facilities seeking to control BNP utilization.
Gifford Lum
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  American journal of clinical pathology     Volume:  126     ISSN:  0002-9173     ISO Abbreviation:  Am. J. Clin. Pathol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-07     Completed Date:  2006-08-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370470     Medline TA:  Am J Clin Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  190-4     Citation Subset:  AIM; IM    
Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Cost-Benefit Analysis
Delivery of Health Care / statistics & numerical data
Diagnostic Tests, Routine / economics,  statistics & numerical data,  utilization*
Health Expenditures
Heart Failure / blood,  diagnosis*
Natriuretic Peptide, Brain / blood*
Practice Guidelines as Topic*
Utilization Review*
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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