Analysis of ordering pattern and cost effectiveness of thyroid function tests for diagnosing thyroid diseases.

Abstract

Objectives: To determine the ordering pattern and cost effective use of thyroid function tests for diagnosing thyroid diseases, aiming to minimize the total cost of diagnosis without compromising the diagnostic accuracy of the tests. Study Design: Retrospective Observational study. Setting: Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad. Period: 1st December 2016 to 31st February 2017. Material & Methods: The data regarding the number of entitled patients and the cost of each of T3, T4 and TSH was determined. Also the number of cases where the thyroid profile was normal were determined and analysis was made about whether was there any need to prescribe full profile. Mean and standard were used for quantitative variables and frequency and percentages were applied for qualitative data. About 1491 patients were included in the study. Results: Mean age of the study sample was 25 ± 6.5 years (range: 1 years to 80 years). There were 579 (39%) males and 912 (61%) females. About 700 (46.9%) patients were entitled. Majority of the cases were from medicine and gynae obstetrics units of the hospital i.e 644 (43.2%) and 549 (36.8%) cases respectively. In about 838 (56.2%) cases, the thyroid function tests were normal. Conclusion: There is a huge financial burden on patients as well on the hospital regarding performing thyroid function tests in clinical setup. There is a need to spread awareness among junior doctors to ensure judicious advising of the thyroid function tests in patients especially in cases coming from low socioeconomic class and in cases of entitled patients, whose burden is from the government funds.