An Important Financial Burden: Unnecessary Test Requests for Viral Hepatitis

Abstract

Cost-effective approaches for using limited financial resources correctly are essential in the healthcare field. Life expectancy has been increasing in developed and developing countries, and nowadays, acute and chronic diseases are being treated with processes that are becoming more expensive. Consequently, increasing pressure on the health budgets of countries around the world is now a reality. The health expenditure percentage of the gross domestic product is expected to climb in future years (1).To decrease this health expenditure, initially, misapplications in health care should be detected. An article by Demiray et al. (2) in the recent issue of the Viral Hepatitis Journal emphasized the costs of unnecessary tests, and provided beneficial information on this subject for clinicians.Unnecessary test requests for viral hepatitis, in particular, are a significant problem in various centers in Turkey. Alpay Ozbek et al. (3) found that 14% of anti-hepatitis A virus total tests and 18% of (anti-HBc) tests were unnecessarily repeated over a three-year period at a university hospital. The rate of inappropriate tests used for the diagnosis of hepatitis A infection was 52.2% in a two-year study at a state hospital. At this same hospital, it was detected that 12.9% of anti-HBs, 12.9% of anti-HBc total, 74.8% of anti-HBc immunoglobulin M (IgM), 83.9% of hepatitis B envelope antigen (HBeAg), and 75.2% of anti-HBe tests were unnecessary, at a total cost of 56.153 Turkish liras (TL) (4). Genc and Aksu (5) found that the percentages of unnecessary test requests were 2.23% in anti-HBs, 0.7% in anti-HBc total, 37.41% in anti-HBc IgM, 44.86%