Pattern, Determinants, and Costing Review of Send-out Tests in a Secondary Care Hospital Setting in Saudi Arabia

Background: The need for advanced laboratory tests, mostly performed at reference laboratories, increases over time. Officials have to choose between “send-out” testing or introducing such tests among their test menus, bearing necessary cost.

Aim: This study aims to identify the distribution pattern of send-out testing at the A Hada Armed Forces Hospital (AHAFH), in Taif relevant cost and associated factors.

Methods: A study review of all send-out tests of all varieties during fiscal year (FY) 2011 was conducted.

Results: It was found that 2,986 reference laboratory tests out of total 3,675,000 tests were processed during the study period, comprising 0.11% of the total test volume. The total cost of send-out testing accounted up to €168,903.5 [range €370.8, minimum €12.2, maximum €383.0, median €50.0, inter-quartile range (IQR) €48.86], and constituting 11.7% of the total laboratory budget in fiscal year (FY) 2011. The variability in the cost of send-out tests was statistically significant [H(6)=898.39, p<0.001]. The cost of send-outs highly correlated with the turnaround time (TAT) (r=0.77, p<0.001).

Conclusions: The study furnishes a database that can be used for conducting an in-depth cost-effectiveness analysis to help introduce priority reference tests to AHAFH laboratory test menu to minimize the “wait time” until disease diagnosis has been done. New measures to adjust send-out testing may be developed to help physicians make sound send-out decision choices.