Doctors Order Fewer Lab Tests When They Know the Cost
Hospitals usually don't give information on charges, study authors say
Tuesday, April 16, 2013
Currently, hospitals typically keep doctors and patients in the dark about the prices of medical services, which contributes to the enormous cost of health care in the United States, according to the researchers.
Their six-month study looked at the use of 62 diagnostic blood tests frequently ordered for patients at the Johns Hopkins Hospital, in Baltimore. Doctors in one group were given the cost of each of the tests while doctors in another group were not provided with that information.
The group of doctors who knew the prices ordered nearly 9 percent fewer lab tests, which saved more than $400,000 over the study period, according to the study appearing April 15 in the journal JAMA Internal Medicine.
There was a 6 percent increase in the number of tests ordered by the group of doctors who did not know the prices.
"We generally don't make decisions based on what is cost-effective or what is known to be absolutely necessary for our patients, but knowing the cost of things appears to make us more thoughtful about what we think might be best for their health," study leader Dr. Leonard Feldman, an assistant professor of medicine at Johns Hopkins, said in a hospital news release.
"There's a lot of waste in medicine because we don't have a sense of the costs of much of what we do," he added.
Feldman said the findings offer "evidence that presenting providers with associated test fees as they order is a simple and unobtrusive way to alter behavior. In the end, we ordered fewer tests, saved money and saved patients from extra needle sticks without any negative outcomes."
Many of the savings seen in the study were the result of comparison shopping. For example, it cost $15.44 for a comprehensive metabolic panel, a blood test that checks fluid and electrolyte status, kidney and liver function, blood sugar levels, and response to various medications. A basic metabolic panel checks many of the same things but cost $3.08.
During the six-month study, the number of comprehensive metabolic panel tests ordered by doctors who knew the price fell by about 8,900, while the number of basic metabolic panels grew by about the same number.
That shift alone saved more than $27,000 over the study period, the researchers said.
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