Practice Economics

Blood test charges vary widely among California hospitals


 

FROM BMJ OPEN

References

Charges for 10 common blood tests showed wide variation among hospitals in California, with the cost of one test ranging from $10 to more than $10,000, Dr. Renee Y. Hsia and her associates reported in BMJ Open.

In 2011, minimum charges for the examined blood tests ranged from $10 to $44. Maximum charges, with the exception of a creatine kinase assay at $628, were all more than $6,000. The highest charge for a lipid panel was $10,169 – more than a thousand times higher than the low of $10, according to Dr. Hsia and her associates (BMJ Open 2014 [doi: 10.1136/bmjopen-2014-005482]).

Large price differences remained after extreme cases were excluded (see graph). The test with the smallest variation between the 5th and 95th percentiles, an automated complete blood count, had a range of $37 to $278 (median, $100). A complete metabolic panel had the largest variation among the 10 blood tests, costing anywhere from $79 to $948 (median, $273).

Teaching hospitals charged significantly less than other hospitals for 7 of the 10 tests, and government hospitals charged less for 5 of the 10, but "it is notable how few characteristics were significant predictors of the charges patients faced. ... A hospital’s case mix and labor cost did not affect charges, nor did the competitiveness of the market or the percentage of uninsured people in the county," wrote Dr. Hsia of the University of California, San Francisco, and her associates.

The study used data from the California Office of Statewide Health Planning and Development. Of the 307 hospitals that reported charges in 2011, between 166 and 189 reported charges for each of the 10 tests included in the study.

lfranki@frontlinemedcom.com

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