Cost and Prevalence of Pre-Analytical Errors: A Narrative Review
Author(s)
Claudia A. Rhoades, PhD, Szu-Yu Z. Kao, PhD, Artem T. Boltyenkov, MBA, PhD, Kinpritma Sangha, MPH, PhD, Taras Dudykevych, PhD, Joshua Savina, MS-CLS;
Siemens Healthineers, Malvern, PA, USA
Siemens Healthineers, Malvern, PA, USA
Presentation Documents
OBJECTIVES: Pre-analytical errors (PAEs) account for approximately 70% of all laboratory testing errors, making them the most common quality failures in the laboratory testing process. These errors occur before sample analysis (pre-analytical phase) and can include mistakes in patient identification, inappropriate specimen collection, and improper sample handling. Minimizing PAEs is crucial because laboratory test results influence 60-70% of clinical decisions within and outside of hospital settings. However, the prevalence and costs associated with PAEs remain uncertain. This review aims to synthesize the current evidence on the prevalence of PAEs and their associated direct and indirect costs.
METHODS: PubMed, MEDLINE, and Google Scholar were searched for peer-reviewed studies published in English between 2000 and 2024 that focused on the prevalence or cost of PAEs. A narrative review of the findings was performed.
RESULTS: A total of 744 abstracts/titles were screened during the database search, resulting in the inclusion of 21 articles in the review. This review encompasses 13 studies on the prevalence of PAEs and 8 studies examining the costs of PAEs. The reported prevalence of PAEs varied, with sample rejection rates ranging from 0.37% to 6.61%. The direct costs of PAEs include personnel and resources utilized for resampling, retesting, and investigating/reporting PAEs. Indirect costs associated with PAEs can arise from delays in diagnosis or treatment, potentially extending a patient’s hospital stay. In clinical laboratories, the direct costs of PAEs could amount to up to 10% of the annual testing budget. Furthermore, the total costs, combining both direct and indirect costs associated with PAEs, could account for 0.2% to 1.2% of hospital operating costs.
CONCLUSIONS: There is considerable variability in the prevalence and costs of PAEs across studies, depending on patient populations and laboratory settings. PAEs impose a significant financial burden that impacts not only laboratories but also patients and hospitals.
METHODS: PubMed, MEDLINE, and Google Scholar were searched for peer-reviewed studies published in English between 2000 and 2024 that focused on the prevalence or cost of PAEs. A narrative review of the findings was performed.
RESULTS: A total of 744 abstracts/titles were screened during the database search, resulting in the inclusion of 21 articles in the review. This review encompasses 13 studies on the prevalence of PAEs and 8 studies examining the costs of PAEs. The reported prevalence of PAEs varied, with sample rejection rates ranging from 0.37% to 6.61%. The direct costs of PAEs include personnel and resources utilized for resampling, retesting, and investigating/reporting PAEs. Indirect costs associated with PAEs can arise from delays in diagnosis or treatment, potentially extending a patient’s hospital stay. In clinical laboratories, the direct costs of PAEs could amount to up to 10% of the annual testing budget. Furthermore, the total costs, combining both direct and indirect costs associated with PAEs, could account for 0.2% to 1.2% of hospital operating costs.
CONCLUSIONS: There is considerable variability in the prevalence and costs of PAEs across studies, depending on patient populations and laboratory settings. PAEs impose a significant financial burden that impacts not only laboratories but also patients and hospitals.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE233
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas