Abstract:
BACKGROUND:Serum folate levels are commonly ordered for multiple indications in the inpatient and emergency department settings. Since mandatory folic acid fortification in 1998, there has been a decreasing prevalence of folate deficiency in the United States. OBJECTIVE:Our objective was to determine the indications, rate of deficiency, charge and cost per deficient result, and change in management per deficient result in serum folate testing in inpatients and emergency department patients. DESIGN:Retrospective analysis of all inpatient and emergency department serum folate tests. METHODS:We analyzed all inpatient and emergency department serum folate tests performed over a 12-month period. We reviewed the charts of 250 patients and all low-normal or deficient serum folate levels to determine indications, comorbidities, and change in management based on result. Charge and cost analyses were performed. SETTING/PATIENTS:All inpatient and emergency department patients with a serum folate test performed at a major medical center in Boston, Massachusetts. RESULTS:A total of 2093 serum folate tests were performed in 1944 patients with 2 deficient levels. The most common indications were anemia without macrocytosis and anemia with macrocytosis. The amount charged per deficient result was $158,022. The cost to the hospital per deficient result was less than $2093. CONCLUSIONS:In folic acid fortified countries, serum folate testing has low utility and poor cost effectiveness for all indications in inpatients and emergency department patients.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Theisen-Toupal J,Horowitz GL,Breu ACdoi
10.1002/jhm.1994subject
Has Abstractpub_date
2013-02-01 00:00:00pages
91-5issue
2eissn
1553-5592issn
1553-5606journal_volume
8pub_type
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