COST BENEFIT OF THE ROUTINE URINALYSIS

Abstract

In the present health care environment, cost-benefit analysis is extremely important. In this screening program, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined. The process of screening was similar to all the studies. The minimal cost utilizing 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist. Initial abnormal urinalysis was found in 4.7% (76/1601) of patients. Upon retesting 1.37% (22/1601) of patients were calculated to have a persistent abnormality. The calculated cost was 1/530/000 Rials (164.5 $) to initially screen all 1601 patients with a dipstick urinalysis or 850 Rials (0.09 $) per patient. The calculated cost to evaluate the 22 patients with any persistent abnormality on repeat dipstick urinalysis was 246/840 Rials (26.5 $) or 11.220 Rials (1.2 $) per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients. Multiple screening dipstick urinalysis in asymptomatic pediatric are costly and should be discontinued. We purpose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years old , in all asymptomatic children.