title: Comparative analytical costs of central laboratory glucose and bedside glucose testing: a College of American Pathologists Q-Probes study.
abstract: BACKGROUND
  One of the major attributes of laboratory testing is cost. Although fully automated central laboratory glucose testing and semiautomated bedside glucose testing (BGT) are performed at most institutions, rigorous determinations of interinstitutional comparative costs have not been performed.
  
  
  OBJECTIVE
  To compare interinstitutional analytical costs of central laboratory glucose testing and BGT and to provide suggestions for improvement.
  
  
  METHODS
  Participants completed a demographic form about their institutional glucose monitoring practices. They also collected information about the costs of central laboratory glucose testing, BGT at a high-volume testing site, and BGT at a low-volume testing site, including specified cost variables for labor, reagents, and instruments.
  
  
  METHODS
  A total of 445 institutions enrolled in the College of American Pathologists Q-Probes program.
  
  
  METHODS
  Median cost per glucose test at 3 testing sites.
  
  
  RESULTS
  The median (10th-90th percentile range) costs per glucose test were 1.18 dollars (5.59 dollars-0.36 dollars), 1.96 dollars (9.51 dollars-0.77 dollars), and 4.66 dollars (27.54 dollars-1.02 dollars) for central laboratory, high-volume BGT sites, and low-volume BGT sites, respectively. The largest percentages of the cost per test were for labor (59.3%, 72.7%, and 85.8%), followed by supplies (27.2%, 27.3%, and 13.4%) and equipment (2.1%, 0.0%, and 0.0%) for the 3 sites, respectively. The median number of patient specimens per month at the high-volume BGT sites was 625 compared to 30 at the low-volume BGT sites. Most participants did not include labor, instrument maintenance, competency assessment, or oversight in their BGT estimated costs until required to do so for the study.
  
  
  CONCLUSIONS
  Analytical costs per glucose test were lower for central laboratory glucose testing than for BGT, which, in turn, was highly variable and dependent on volume. Data that would be used for financial justification for BGT were widely aberrant and in need of improvement.
authors.affiliation: Department of Pathology, State University of New York, Downstate Medical Center, Brooklyn 11203-2098, USA. phowanitz@downstate.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Howanitz
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Jones
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D001800:Blood Specimen Collection / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D007755:Laboratories, Hospital / Q000191:economics*; D019095:Point-of-Care Systems / Q000191:economics*; D011785:Quality Assurance, Health Care; D014481:United States
chemical_list: D001786:Blood Glucose