[Unnecessary test repeats in viral hepatitis serology]

Abstract

Inappropriate laboratory testing constitutes a vast burden regarding the cost and the workload for health care system. Unnecessary repetition of tests is one of the most common reasons accounting for inappropriate laboratory utilization. A wide spectrum of tests are utilized to diagnose hepatitis A and B infections in Turkey because of the high seroprevalence rates. The present research aimed to determine the rate of unnecessary repeat testing of anti-HAV total and anti-HBc used in serological diagnosis of hepatitis A and B infections and to discuss the possible solutions for this problem. Laboratory records of the serology laboratory of Dokuz Eylul University Hospital, dating between May 2002 - May 2005, were evaluated retrospectively. Unnecessary repeat testing was defined as the repetition of anti-HAV total and/or anti-HBc for the patients positive for one or both of the tests. During the study period of three years, a total of 10.658 anti-HAV total and 13.047 anti-HBc were tested of which 8.550 (80%) and 4.959 (38%) were found positive, respectively. Out of the positive results, 1.197 (14%) anti-HAV total and 904 (18%) anti-HBc tests were detected to be unnecessarily repeated tests. The estimated cost of a total of 2101 unnecessarily repeated tests was found approximately 17.000 US Dollars. Our data display that considerable amount of unnecessary testing takes place in serological testing of viral hepatitis. Prevention of inappropriate laboratory requests by clinicians would help to diminish the work load in serology laboratories and the cost both for the hospitals and the country.