title: Estimated costs of false laboratory diagnoses of tuberculosis in three patients.
abstract: We estimated direct medical and nonmedical costs associated with a false diagnosis of tuberculosis (TB) caused by laboratory cross-contamination of Mycobacterium tuberculosis cultures in Massachusetts in 1998 and 1999. For three patients who received misdiagnoses of active TB disease on the basis of laboratory cross-contamination, the costs totaled U.S. dollars 32618. Of the total, 97% was attributed to the public sector (local and state health departments, public health hospital and laboratory, and county and state correctional facilities); 3% to the private sector (physicians, hospitals, and laboratories); and <1% to the patient. Hospitalizations and inpatient tests, procedures, and TB medications accounted for 69% of costs, and outpatient TB medications accounted for 18%. The average cost per patient was dollars 10873 (range, dollars 1033-dollars 21306). Reducing laboratory cross-contamination and quickly identifying patients with cross-contaminated cultures can prevent unnecessary and potentially dangerous treatment regimens and anguish for the patient and financial burden to the health-care system.
authors.affiliation: Massachusetts Department of Public Health, Boston, Massachusetts, USA. Jill.Northrup@State.MA.US
authors.forename: Jill M
authors.initials: JM
authors.lastname: Northrup
authors.forename: Ann C
authors.initials: AC
authors.lastname: Miller
authors.forename: Edward
authors.initials: E
authors.lastname: Nardell
authors.forename: Sharon
authors.initials: S
authors.lastname: Sharnprapai
authors.forename: Sue
authors.initials: S
authors.lastname: Etkind
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Driscoll
authors.forename: Michael
authors.initials: M
authors.lastname: McGarry
authors.forename: Harry W
authors.initials: HW
authors.lastname: Taber
authors.forename: Paul
authors.initials: P
authors.lastname: Elvin
authors.forename: Noreen L
authors.initials: NL
authors.lastname: Qualls
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Braden
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000191:economics; D015373:Bacterial Typing Techniques; D016358:Contact Tracing / Q000191:economics; D003951:Diagnostic Errors / Q000191:economics*; D004866:Equipment Contamination; D005189:False Positive Reactions; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007753:Laboratories / Q000191:economics* / Q000592:standards; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D013048:Specimen Handling; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents