Surgical vampires and rising health care expenditure: reducing the cost of daily phlebotomy

Arch Surg. 2011 May;146(5):524-7. doi: 10.1001/archsurg.2011.103.


Objective: To determine whether simply being made continually aware of the hospital costs of daily phlebotomy would reduce the amount of phlebotomy ordered for nonintensive care unit surgical patients.

Design: Prospective observational study.

Setting: Tertiary care hospital in an urban setting.

Participants: All nonintensive care unit patients on 3 general surgical services.

Intervention: A weekly announcement to surgical house staff and attending physicians of the dollar amount charged to nonintensive care unit patients for laboratory services during the previous week.

Main outcome measure: Dollars charged per patient per day for routine blood work.

Results: At baseline, the charges for daily phlebotomy were $147.73/patient/d. After 11 weeks of residents being made aware of the daily charges for phlebotomy, the charges dropped as low as $108.11/patient/d. This had a correlation coefficient of -0.76 and significance of P = .002. Over 11 weeks of intervention, the dollar amount saved was $54,967.

Conclusion: Health care providers being made aware of the cost of phlebotomy can decrease the amount of these tests ordered and result in significant savings for the hospital.

MeSH terms

  • Awareness*
  • Blood Cell Count / economics*
  • Blood Chemical Analysis / economics*
  • Cost Control / methods
  • General Surgery / education*
  • Health Expenditures / trends*
  • Hospital Charges / trends
  • Hospital Costs / trends*
  • Hospitals, University / economics
  • Hospitals, Urban / economics
  • Humans
  • Internship and Residency
  • Phlebotomy / economics*
  • Prospective Studies
  • Rhode Island
  • Unnecessary Procedures / economics