Reducing Tuberculosis Detection Costs

Use of sputum culture for diagnosis of tuberculosis is an inefficient detection technique in a disease of declining prevalence. We found such testing at our 400 bed acute care hospital resulted in less than 2 percent positive when done with prior patient screening. In an effort to minimize detection costs, restrictions requiring that a tuberculin skin test and chest roentgenogram be performed prior to processing the MTB culture were instituted. This resulted in 672 fewer cultures being processed in the trial year, a significant (44 percent) reduction compared to the prior year. At $50.00 per culture, this represents an annual savings of more than $30,000.