A low-cost initiative to reduce duplicate hepatitis B virus serological testing

Area of Science:

• Clinical diagnostics
• Laboratory medicine
• Public health virology

Background:

• Multiple laboratories in Alberta, Canada, offer hepatitis B virus (HBV) serology testing.
• Concerns existed regarding duplicate testing of single specimens during inter-laboratory referrals.
• A strategy was needed to minimize redundant testing for anti-HBs and HBsAg markers.

Purpose of the Study:

• To evaluate the effectiveness of a requisition stamp in reducing duplicate HBV serology tests.
• To quantify the reduction in duplicate testing for HBsAg and anti-HBs markers.
• To estimate the cost savings associated with reduced duplicate testing.

Main Methods:

• Implemented a requisition stamp to indicate prior testing on referred specimens (May-August 2016).
• Analyzed HBV serology testing data from two laboratories between January 2015 and December 2017 (n=803,637).
• Identified and calculated costs of tests performed on the same individual within a 3-day window.

Main Results:

• Duplicated HBsAg tests decreased from 20.8% to 3.7%; anti-HBs tests decreased from 18.4% to 2.5%.
• Estimated annual savings of $86,427 CAD for HBsAg and $82,522 CAD for anti-HBs supply costs.
• Significant reduction in duplicate testing observed post-stamp implementation.

Conclusions:

• The requisition stamp initiative effectively reduced duplicate HBV serology tests between laboratory sites.
• This low-cost intervention shows potential for application to other duplicated serological markers.
• The strategy offers broad cost-saving benefits for laboratory testing processes.