Excess Cost of Routine Daily Laboratory Tests among Internal Medicine Departments at Jordan University Hospital: a Pilot Study

Introduction: Laboratory tests have become the single highest-volume medical activity; this is a result of physicians’ dependence on them. They order them even in cases where they are deemed unnecessary clinically and have no impact on patient care and treatment. One of the practices that lead to “over-investigation” in terms of these tests is “routine testing”, which yields to an excess cost both monetarily as well as in other aspects. Thus, the purpose of this study is to investigate routine laboratory ordering practices among internal medicine departments at Jordan University Hospital to determine the amount and cost of unnecessary routine lab tests ordered. Methods: We reviewed the data of 30 patients that were admitted for a minimum of 5 days, aged over 18 years old, and not pregnant in various internal medicine departments (respiratory, hematology, gastroenterology, infectious diseases, neurology, nephrology and cardiology). Through criteria set by previously published studies, and the experience of internal medical consultants we calculated the cost of excess labs for all the patients that met aforementioned criteria during a time span of 1 month. Results: The average age of the sample was 57.3 years, spread out among the different departments. The mean average excess cost per patient per day was $43.1 (± 25.8) ranging from 0 to $103.3, with no significant difference between age and department. Conclusion: A potential to lower hospital admission cost lies in these unnecessary excess laboratory tests, however further studies with a larger sample sizes are needed, as well as studies assessing the non-monetary cost caused by over-investigation.