PEDIATRICS Vol. 96 No. 2 August 1995, pp. 230-234
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Tershakovec, A. M.
Right arrow Articles by Shannon, B. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tershakovec, A. M.
Right arrow Articles by Shannon, B. M.

The Cost of Implementation of the Clinical Laboratory Improvement Amendments of 1988—The Example of Pediatric Office-Based Cholesterol Screening

Andrew M. Tershakovec MD1, S. Diane Brannon PhD2, Michael J. Bennett PhD3, and Barbara M. Shannon PhD2

1 The Children's Hospital of Philadelphia, Philadelphia
2 The Pennsylvania State University, University Park, PA
3 University of Texas Southwestern Medical Center, Dallas

Objective. To measure the additional costs of office-based laboratory testing due to the implementation of the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88), using cholesterol screening for children as an example.

Methods. Four-to ten-year-old children who received their well child care at one of seven participating pediatric practices were screened for hypercholesterolemia. The average number of analyses per day and days per month were derived from the volume of testing completed by the practices. Nurses and technicians time in the screening process were measured and personnel costs were calculated based on salary and fringe benefit rates. Costs of supplies, analyzing control samples, instrument calibration, and instrument depreciation were included. Costs estimates of screening were then completed. CLIA '88 implementation costs were derived from appropriate proficiency testing and laboratory inspection programs.

Results. In six practices completing a low volume of testing, 2807 children (5 to 6 children per week) were screened during the observation period, while 414 (about 25 children per week) were screened in one high-volume practice implementing universal screening over a 4-month period. For the six low-volume practices, the cost of screening was $10.60 per child. This decreased to $5.47 for the high-volume practice. Estimated costs of CLIA '88 implementation, including additional proficiency testing and laboratory inspection, added $3.20 per test for the low-volume practices, and $0.71 per test for the high-volume testing.

Conclusions. Implementation of CLIA adds significantly to the cost of office-based chemistry laboratory screening. Despite these additional expenses, the cost of testing is still within a reasonable charge for laboratory testing, and is highly sensitive to the volume of tests completed.

Submitted on June 6, 1994
Accepted on November 4, 1994




This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
H. J. Binns, S. LeBailly, H. G. Gardner, and for the Pediatric Practice Research Group
The Physicians' Office Laboratory: 1988 and 1996 Survey of Illinois Pediatricians
Arch Pediatr Adolesc Med, June 1, 1998; 152(6): 585 - 592.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
J. T Benjamin
Reply
Clinical Pediatrics, November 1, 1996; 35(11): 605 - 606.
[PDF]