(181) Utilization of Comprehensive Metabolic Panels in Regular Patient Management: Investigation of Patient Follow-up Based on Abnormal Test results in a Claims Laboratory Test Result Database

Publication Number: 842

Background: Blood tests like, a comprehensive metabolic panel (CMP), are a common diagnostic tool used by physicians to help assess and manage patient overall health.

Objectives: This study sought to investigate patterns of laboratory follow-up as well as healthcare resource utilization and costs based on CMP results using the MarketScan Laboratory Database.

Methods: Adult patients with laboratory test result data for a full CMP on a single day on or after January 1, 2016 were selected in the MarketScan Laboratory Database. The day of the CMP served as the index date and patients were required to have continuous medical and pharmacy eligibility for 6-months prior to and following index. Laboratory test results were assessed at index and classified as low, normal, or high for each of the 14 tests in the CMP, and patients were classified as having 0, 1, or 2 abnormal tests (AT) at index. The proportion of patients with a prior or subsequent test, an emergency room visit or inpatient admission, and mean healthcare costs were assessed in the pre- and post-periods to provide insight into the utilization of common blood tests in regular patient management.

Results: A total of 74,272 patients had complete results for a CMP and qualified for the analyses. MeanSD age of the population was 50.816.3 and 54.6% were female. The greatest proportion of patients had no ATs (42.6%) followed by patients with 1 AT (36.3%) and 2+ ATs (21.1%). The most common ATs were glucose (35.0%) followed by CO2 (9.0%) and creatinine (7.0%). Patients who had no ATs (19.0%) were significantly less likely to have a subsequent test result in the follow-up period compared to patients with 1 (27.7%) or 2+ (39.7%) ATs at index. The rate of subsequent ATs also increased with increasing ATs at index. Consistent with the indication of worse overall health, patients with increased ATs at index evidenced significantly increased proportions of patients with 1 IP admission (0 ATs: 2.6%, 1 AT: 3.9%, 2+ ATs: 8.9%, p< 0.001) or ER visit (0 ATs: 9.5%, 1 AT: 10.7%, 2+ ATs: 15.4%, p< 0.001) as well as significantly higher total healthcare costs (0 ATs: $4,23814,051, 1 AT: $5,52917,137, 2+ ATs: $9,28727,321, p< 0.001) over the post-period.

Conclusions: Trends for increased occurrence of subsequent testing among patients with ATs at index suggest that CMPs are being used to monitor patient health. The association found here between ATs at index and increased healthcare resource utilization and costs over the post-period highlights the importance of patient follow-up.