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BMJ Open. 2014 Aug 14;4(8):e005482. doi: 10.1136/bmjopen-2014-005482.

Variation in charges for 10 common blood tests in California hospitals: a cross-sectional analysis.

Author information

  • 1Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.
  • 2Department of Economics, Indiana University-Purdue University, Indianapolis, Indiana, USA.

Erratum in

  • BMJ Open. 2014;4(8):e005482corr1. Nath, Julia P [corrected to Nath, Julia B].

Abstract

OBJECTIVES:

To determine the variation in charges for 10 common blood tests across California hospitals in 2011, and to analyse the hospital and market-level factors that may explain any observed variation.

DESIGN, SETTING AND PARTICIPANTS:

We conducted a cross-sectional analysis of the degree of charge variation between hospitals for 10 common blood tests using charge data reported by all non-federal California hospitals to the California Office of Statewide Health Planning and Development in 2011.

OUTCOME MEASURES:

Charges for 10 common blood tests at California hospitals during 2011.

RESULTS:

We found that charges for blood tests varied significantly between California hospitals. For example, charges for a lipid panel ranged from US$10 to US$10,169, a thousand-fold difference. Although government hospitals and teaching hospitals were found to charge significantly less than their counterparts for many blood tests, few other hospital characteristics and no market-level predictors significantly predicted charges for blood tests. Our models explained, at most, 21% of the variation between hospitals in charges for the blood test in question.

CONCLUSIONS:

These findings demonstrate the seemingly arbitrary nature of the charge setting process, making it difficult for patients to act as true consumers in this era of 'consumer-directed healthcare.'

KEYWORDS:

Health Economics; Internal Medicine

PMID:
25127708
PMCID:
PMC4139626
DOI:
10.1136/bmjopen-2014-005482
[PubMed - indexed for MEDLINE]
Free PMC Article
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