Utility of measuring prothrombin and activated partial thromboplastin times in a community hospital

PURPOSE: To prove an excessive use of prothrombin-time (PT) and activated partial thromboplastin time (APTT) in a regional hospital of A-B nivel with 168 beds. MATERIAL AND METHODS: All studies of PT and APTT were compiled during one month. In accordance with assistance type (emergency, inpatient or outpatient), the following parameters were analysed: services distribution and assistance type, justification of haemostasis studies, according to the American Medical Association criteria modified for Erban et al., abnormal findings appeared and economical cost study of the tests, according to the justification request. RESULTS: The total number of haemostasis tests performed in that month was 706, with a daily mean of 22.7. Seven hundred and six were PT analysis and 606 APTT. Fifty-six percent were not adequate. This corresponded to 82.5% of the requests in inpatients, 56% of the outpatients and 33.5% of emergency patients. Only 51 analyses were abnormal, that means 7.4% of all studies. From these, 13 were in inpatients (7.64% from the whole of the patients requests), 11 were outpatients (3.52%) and 27 emergencies (12.8%). The economical burden within the month studied amounted up to 629.760 ptas. CONCLUSIONS: The number of haemostasis screening tests was excessive. The correction of this inappropriate use could improve the patient assistance and could decrease the cost, without impairing, and perhaps increasing, the assistential quality.