Parkerson G R
J Fam Pract. 1978 Nov;7(5):1001-7.
The cost of laboratory tests in the ambulatory primary care setting was analyzed to study relationships among cost to the patient, degree of abnormality of results, and physician follow-up of abnormal results. Laboratory fees constituted 32 cents of the total dollar for office charges. Considering only that portion of patient money spent for laboratory blood tests, 20 cents of the dollar went for tests with normal results, 25 cent for abnormals that were followed up by physicians, and 55 cents for abnormals that were not followed up. Separate analysis including only the abnormals was performed using two methods that differed as to whether or not low degree abnormals were considered worthy follow-up. Even when considering follow-up of this group unnecessary, 30 cents of the patient's dollar for abnormals was spent on appreciably high abnormal tests that were not followed up. This represents a substantial cost to the patient, from which no benefit can be envisioned.
分析了门诊基层医疗环境中实验室检查的成本，以研究患者成本、检查结果异常程度以及医生对异常结果的跟进之间的关系。实验室费用占办公室收费总额的32美分。仅考虑患者用于实验室血液检查的那部分费用，1美元中有20美分用于结果正常的检查，25美分用于医生跟进的异常检查，55美分用于未跟进的异常检查。使用两种方法对仅包括异常检查的情况进行了单独分析，这两种方法在低度异常是否被视为值得跟进方面存在差异。即使认为对这组异常情况进行跟进没有必要，患者用于异常检查的1美元中仍有30美分花在了未跟进的明显高度异常检查上。这对患者来说是一笔巨大的成本，看不到任何益处。
