Laboratory test costs: attitudes and awareness among staff in a regional hospital

There continues to be an unrelenting rise in the volumes of laboratory tests ordered in medicine, which is both expensive and has the potential for over-investigation. We performed a quantitative, observational, cross-sectional study of staff with the authority to initiate a laboratory test, using a voluntary, anonymous questionnaire. Our aim was to assess the awareness of and attitudes towards laboratory test costs. 226 surveys were completed over 2 weeks in June, 2012. Most numerous respondents were Staff nurses 125 (55.3%) followed by senior house officers (SHOs) 26 (11.5%) and clinical nurse managers/specialists (CNMs and CNSs) 23 (10.2%). The majority of staff, 191(85.6%), felt unaware of the cost of laboratory tests, which they ordered. For non urgent tests, the majority of respondents, 136 (61.8%) felt cost was either quite of very important. For urgent tests, the majority of respondents, 188 (84.6%) felt cost was of minor or of no importance. Doctors felt more aware of costs than nurses (26.9% vs. 9.3%) and doctors test cost estimates were correct more often than nurses (33% vs. 21%). The results indicate poor awareness of laboratory test cost amongst doctors and nurses. Given the expenditure incurred by a rise in the volume of tests and the potential for over-investigation for patients, strategies for improving the awareness of and attitudes towards laboratory tests need to be developed.