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June 24, 1983

Cost-effective Medical Care

Author Affiliations

Allen Soffer University of Missouri School of Medicine Kansas City

JAMA. 1983;249(24):3302. doi:10.1001/jama.1983.03330480018009

To the Editor.—  The recent editorial by Lundberg concerning overuse of laboratory tests was interesting and appropriate in light of the ever-increasing cost of health care (1983; 249:639). We have previously reported on a comparison of laboratory and ancillary service use between endocrinologists and nonendocrinologists treating diabetic ketoacidosis in a university setting.1 Although the period of hospitalization was similar, the total number of laboratory tests and roentgenographic procedures and average number per patient per hospital day were notably increased in the specialist group, 17.02% and 13.13%, respectively. In a similar study comparing internists and family practitioners, we found that total laboratory use and length of stay per patient were increased in the internal medicine group by 67.77% and 10.65%, respectively.2 In both studies, no difference in clinical outcome was noted. In addition, we compared laboratory test use in diabetic ketoacidosis at the same hospital in 1975 and 1980.