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.