Cost savings generated by restricting blood test use in a department of internal medicine.

Study objective: to evaluate cost savings generated by a concerted effort t o restrict routine use of biochemistry, hematology, and clotting tests in i npatients. Study site: 46-bed internal medicine department in a teaching ho spital. Methods, for one month, blood samples were drawn only on the day fo llowing admission, then no more than twice a week starting on the fourth da y at the earliest. The comparison period was the month preceding the study. The number of blood samples drawn per patient was determined from nurse ac tivity logs. Total and mean numbers of blood sample procedures were determi ned per hospital day and per admission. Costs of biochemistry, hematology, and clotting tests performed in the patients were calculated. Protocol devi ations (permitted provided they were recorded) and adverse experiences were reviewed. Results. as compared to the reference period, restricting blood test use resulted in a decrease in the weekly number of blood sampling proc edures from 2.5 to 2.14 per patient (- 14.4%) and in cost savings of 4.75 F rench francs per day per patient. Costs per admission decreased by 18%. The cost savings were due mainly (60.1%) to decreases in repeat blood cell cou nts and, above all, in serum electrolyte and glucose determinations (8.1%).