Costs and stewardship of laboratory tests in the Capital Health District

Abstract

Responsible use of diagnostic resources benefits the Canadian healthcare system. Educating clinicians about the costs of laboratory tests can reduce corresponding resource use, both by encouraging substitutions with appro- priate and less-expensive alternatives, and by reducing overall diagnostic workup loads where warranted. To that end, this paper presents the costs of commonly used laboratory tests, and of some less-expensive alternatives, for the Capital District Health Authority of Nova Scotia, Canada. It then compares the aggregate costs of representa- tive brief and elaborate workups for six common patient presentations. When used appropriately, initial workups composed of fewer test alternatives can save between $11.27 (abdominal pain) and $103.63 (shortness of breath) per workup without affecting patient care. Making judicious test substitutions can also provide savings. Clinicians are encouraged to consider these costs and alternatives when providing future patient care.