Study: Knowing Costs May Prompt Less Patient Testing by Doctors

A new study reveals that when physicians are aware of the price of hospital medical testing, they tend to order fewer tests.

The research revealed that, at one hospital, doctors ordered about 9 percent less laboratory tests when they could see the price displayed on their records systems, said Reuters Health. “(Before the study) we saw a lot of waste. We saw a lot of tests that didn’t need to be ordered,” said Dr. Leonard Feldman, lead author from The Johns Hopkins University School of Medicine in Baltimore.

The researchers considered that physicians may likely order too many tests because they are unaware of their costs, wrote Reuters Health. Feldman and his colleagues, writing in JAMA Internal Medicine, said that some $226 billion was spent in 2011 in over-treatment and unnecessary testing.

The greater issue is that inadequate or inappropriate testing places patients at risk; for instance, by harm caused by additional testing and procedures, noted Reuters Health. “The rational approach to ordering tests is something we should all be interested in, and something—if we did better—that would save the system money and save the patients the horror of causing harm,” Feldman said.

And, while over-testing could present potential risks in the event patients are subjected to riskier testing procedures, not conducting needed testing could place patients in jeopardy. Dr. William Tierney, who wrote an accompanying editorial accompanying to the study, told Reuters Health that the study did not show if doctors were ordering tests more appropriately by minimizing testing or if doctors were cutting down on testing that patients needed, but were not receiving.

Consider that appropriate testing enables early diagnosis in a wide array of diseases and disorders including cancers, diabetes, Alzheimer’s disease, and Parkinson’s disease to name just a few. Early diagnosis has long been linked to better and more efficacious treatments, even cures.

For the study, the team pulled together a list of some of the more popular and expensive testing ordered at The Johns Hopkins Hospital. Reuters Health explained that the researchers had the hospital’s record system displaying testing costs from November 2009 to May 2010. Physicians were only told that testing costs were displayed as part of a research product, and only if they asked, said Reuters Health.

The team learned that doctors ordered, on average, 3.4 lab tests for each hospitalized patient per day during the half-year that prices were displayed, said Reuters Health, In 2008-2009, before costs were displayed, physicians ordered 3.7 tests per patient per day.