COST-EFFECTIVENESS OF LABORATORY TESTING IN AL ZAHRAA TEACHING HOSPITAL, AL NAJAF AL-ASHRAF, IRAQ

The aim: To develop a quantitative tool to identify the cost and benefits of the appropriate and inappropriate laboratory tests. Materials and methods: This is a retrospective study, conducted in Al Zahraa teaching hospital for children's health and maternity in a period between March 2021 to March 2022. We study the total laboratory investigation done in three years; before the COVID-19 era (1-3-2018 to 1-3-2019) and two consecutive years (1-3-2020 to 1-3-2021 and 1-3-2021 to 1-3-2022) to exclude the effect of COVID-19 pandemic on the results. And try to divide these test numbers according to each hospital department and the position of the test ordering doctor (senior or junior). We compare the total number of laboratory investigations with the total patient seeking medical care in Al Zahraa hospital, out or inpatient, i.e., ORDERING INDEX. Also, we calculate the (AVERAGE ORDERING INDEX) by dividing the number of all ordered tests by one specific test. Results: The total number of laboratory tests ordered in three (pre and peri COVID-19 pandemic) years show a significant increment in the last year (78249, 73600, and 1740249) respectively. Test ordering index, in the same way, shows significant increments over years (0.65, 0.64 Aand11.2) respectively. Biochemistry investigations constitute the largest proportion (50%) of all investigations that have been ordered last year. CBC is the most commonly ordered single test, in outpatient clinics, it is done 19510 times (Obstetrics and Gynecology 11850 vs Pediatric 7660). The positive (abnormal) results were only 4.8%. Conclusion: For more and more years, laboratory investigations have been overused. A large number of normal results indicate that the test order was chosen at random. The most commonly overused test is the complete blood count.