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2019, Cilt 17, Sayı 1, Sayfa(lar) 017-022
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Unnecessary Laboratory Test Requesting for the Diagnosis of Iron Deficiency Anemia and Cost Effectivity
Volkan Savaş, Tülay Köken
Afyonkarahisar Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Tıbbi Biyokimya AD, Afyon
Keywords: Unnecessary test requesting; iron deficiency anemia; cost effectivity

Objective: The unnecessary test requesting has significant effect in the laboratory workload. The unnecessary demand and the additional cost of performed tests were discussed through the anemia approach algorithm.

Materials and Methods: We retrospectively investigated patients applied to our hospital, performed complete blood count (CBC) and iron parameters (Fe, TİBC, ferritin) simultaneously. When data were obtained; pregnancy, child and nephrology cases were excluded. Cases were divided into four groups; the first group had hemoglobin and iron parameters within the normal range, the second group had both low hemoglobin and iron levels, the third group had hemoglobin within normal range but iron levels were under the reference interval, the fourth group had hemoglobin under the reference interval but the iron parameters were within normal range.

Results: 566 cases were performed CBC and iron parameters simultaneously. In the first group, 301(%53,1) cases had unnecessary test requesting. In the second group 116(%20,1) cases; in the third group 104(%18,3) cases; in the fourth group 45(%7,9) cases were present. Current prices of Health Communication Application; Fe: 1,21TL(0,22 EUR), TIBC: 1,21TL(0,22 EUR), Ferritin 5.5TL(1,01 EUR). A total payment of 7,92TL(1,45 EUR) has been made for a single patient. The additional cost paid for 301 cases in a month, is 2,383,92TL(445,38 EUR).

Conclusion: The unnecessary test requests happen when the clinicians worry about the missing diagnosis. If number of requests increases, the likelihood of being out of the reference range will increase. The clinician and laboratory specialists have to prepare algorithms together and follow. Especially reflex and reflective tests may be useful.


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