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. 2023 Mar 27;38(12):e98.
doi: 10.3346/jkms.2023.38.e98.

Temporal Change in the Use of Laboratory and Imaging Tests in One Week Before Death, 2006-2015

Hyun Ah Kim  1   2 , Minseob Cho  3 , Dae-Soon Son  4
Affiliations

Temporal Change in the Use of Laboratory and Imaging Tests in One Week Before Death, 2006-2015

Hyun Ah Kim et al. J Korean Med Sci. .

Abstract

Background: To analyze the trends in laboratory and imaging test use 1 week before death among decedents who died in Korean hospitals, tests used per decedents from 2006 to 2015 were examined by using the National Health Insurance Service-Elderly Sample Cohort (NHIS-ESC) dataset.

Methods: The study population consisted of decedents aged ≥ 60 years old with a history of admission and death at a hospital, and tests recorded in the payment claims for laboratory and imaging tests according to the Healthcare Common Procedure Coding System codes were examined. Twenty-eight laboratory and 6 imaging tests were selected. For each year, crude rates of test use per decedents in each age and sex stratum were calculated. Regression analysis was used to examine the temporal changes in the test use.

Results: During the follow-up period, 6,638 subjects included in the sample cohort died. The number of total laboratory and imaging tests performed on the deceased increased steadily throughout the study year from 10.3 tests/deceased in 2006 to 16.6 tests/deceased in 2015. The use of tests increased significantly in general hospitals, however, not in nursing hospitals. Laboratory tests showed yearly increase, from 9.46/deceased in 2006 to 15.57/deceased in 2015, an annual increase of 7.39%. On the other hand, the use of imaging increased from 0.86/deceased in 2006 to 1.01/deceased in 2015, which was not statistically significant.

Conclusion: The use of tests, especially laboratory tests, increased steadily over the years even among those elderly patients at imminent death. Reducing acute healthcare at the end of life would be one target not only to support the sustainability of the health care budget but also to improve the quality of dying and death.

Keywords: Imaging Test; Laboratory Test; Medical Overuse; Terminal Care.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. The number of tests performed on decedents in a week before death from year 2006–2015. (A) Nursing hospital, (B) General hospital.
Fig. 2
Fig. 2. The proportion of decedents who had 0, 1–10, and > 10 tests in a week before death in year 2006 and 2015.
* denoted P < 0.05, *** denotes P < 0.001.
See this image and copyright information in PMC

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