Doctors order less expensive lab tests when they know the cost

If doctors were better informed about the cost of lab tests, they would request fewer of them for their patients or look for cheaper alternatives, Hopkins researchers have found.

Researchers at The Johns Hopkins Hospital put the price on some blood tests for six months and found use of tests declined 9 percent. The hospital saved $400,000 over the six months.

The results of the study were published online in JAMA Internal Medicine.

Hospitals don't normally display the price of tests to doctors.

“We generally don’t make decisions based on what is cost-effective or what is known to be absolutely necessary for our patients, but knowing the cost of things appears to make us more thoughtful about what we think might be best for their health,” Dr. Leonard S. Feldman, an assistant professor of medicine at the Johns Hopkins University School of Medicine and leader of the study, said in a statement.  “There’s a lot of waste in medicine because we don’t have a sense of the costs of much of what we do.”

Doctors generally chose the cheaper test when shown the prices. The exception was the most expensive diagnostic tests. Researchers said that was likely because those were specialized tests with no alternative.

Feldman said the study's results don't necessarily mean doctors should always choose the less expensive test. Sometimes it is best to order many tests when doctors are stumped about the diagnosis of a patient. The tests may be cheaper than keeping the patient in the hospital while doctors figure out what is wrong.

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