Spending in the U.S. for diagnostic tests is puny when compared to the impact this spending has on health care. The information these tests provide influences the majority of health care decisions. Comprising the most significant portion of a person’s medical record, lab results are critical in all diagnoses, and essential to monitor chronic diseases. They hold the key to unlocking the potential of personalized medicine and therapeutics. Though the appropriate use of lab tests is integral to high-quality health care, tests that serve as quality measures are underused in practice.

Spending on laboratory services accounts for only 2.3 percent of U.S. health care expenditures and 2 percent of Medicare expenditures. At the same time, diagnostic tests are an essential part of modern medicine, and the information they provide influences most health care decision making. Advances in technology are likely to increase the role these tests play in detecting, treating, and monitoring disease.

When diagnostic tests are appropriately used, they can lead to earlier, more targeted health care interventions, averting adverse health outcomes and unnecessary costs. That is why direct measures of test use—such as cervical cancer screening, LDL cholesterol screening following a heart attack, and Chlamydia screening—are often used to measure quality of care.

Unfortunately, tests that are evidence-based standards of care are often underused. A sentinel study by the RAND Corporation indicated that, based on an analysis of 102 diagnostics based quality indicators in 30 preventive, acute, and chronic conditions, these diagnostic tests were underused 51 percent of the time.

In 2011, 47.1 percent of aggregate hospital costs were for the top 20 most expensive conditions. The top five conditions accounted for nearly one-fifth of the total aggregate costs for all hospitalizations (18.5%). Septicemia resulted in an aggregate cost of $20.3 billion or 5.2 percent of the total aggregate cost for all hospitalizations and was the most expensive condition treated.

Sepsis is the leading cause of death in American hospitals: it occurs in more than 750,000 patients in the United States annually and is responsible for more than 210,000 deaths. Approximately 40% of all intensive care unit patients have sepsis on admission to the intensive care unit or experience sepsis during their stay in the intensive care unit.

Sepsis-related deaths are preventable for as many as 30 percent of patients – 70,000 American lives each year! How? By timely diagnosing the underlying cause of sepsis before the patient gets into ER.
Sepsis Fact Sheet.

The National Committee for Quality Assurance (NCQA) found that low compliance with diagnostics-based quality measures for diabetes, cardiovascular disease, colorectal cancer, and breast cancer alone was linked to 56,200 avoidable adverse health events, up to 34,000 avoidable deaths, and $899 million in avoidable health care costs in 2004. These number have increased since then, but no statistical data is available to LabFlorida at this time.