Unnecessary Blood Tests Plunge After Cost Reminders: Study

TUESDAY May 17, 2011 -- Reminding surgical staff about the expense of taking daily blood samples (phlebotomy) from patients for routine blood work appears to reduce the practice, a new study finds.

"The use of laboratory tests has been rapidly increasing over the past few decades to the point where phlebotomy is a substantial proportion of hospital expenditure, and much of it is unwarranted," wrote Dr. Elizabeth A. Stuebing, of the University of Miami, and Dr. Thomas J. Miner, of Brown University in Providence, R.I.

They obtained data on daily phlebotomy and associated charges for nonintensive care unit patients in three surgical services at Rhode Island Hospital. They calculated the amount spent on taking blood samples and laboratory tests per patient and for all patients.

For 11 weeks, the researchers made weekly announcements to surgical staff and attending physicians about total phlebotomy costs and charges per patient per day averaged over the previous week.

At the start of the study, average per-patient daily costs were about $148 and the overall weekly cost was $36,875. During the study, the lowest per-patient phlebotomy charge was $108 (27 percent lower) and the lowest overall weekly cost was $25,311. By the end of the 11-week study, about $55,000 had been saved, according to the researchers.

They said the intervention was successful and the implementation costs were negligible.

"We focused on simply providing the economic implications of wasteful ordering habits, specifically regarding phlebotomy," the researchers wrote. "This study successfully showed that even without technical and time-consuming interventions, test ordering behavior can be greatly reduced by making health care providers aware of costs."

The study appears in the May issue of the journal Archives of Surgery.

More information

The U.S. National Heart, Lung, and Blood Institute has more about blood tests.

Posted: May 2011


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