The utilisation and notional cost of laboratory tests in primary health care in UAE following introduction of direct charges

Abstract EN

Introduction : In 1997, the UAE Ministry of Health (MOH) introduced direct charges fur laboratory tests lor non-local residents.

This was part of a strategy to generate revenue and to reduce unnecessary demand for laboratory tests.

The aim of this study was to determine the impact of the dcci.sion on the utilisation and notional cost of laboratory tests in primary health care.

Material and Methods : A retrospective, cross section study comparing the frequency of laboratory investigations performed in two primary heath care centres in Abu-Dhabi city before and after the MOH decision.

One centre, providing PHC services for non-national population mainly, was used as a study centre and the other, serving mainly national citizcns, as a control.

The period of July and August was studied the year before introducing the charge and one year after.

From the health centrc registration books we collected data that included the attendance figures and the number of tests ordered.

Also, we calculated the notional cost of laboratory services of both centres.

Results : There was 55 % reduction of the total number of laboratory investigations in the study centre compared with I % reduction in the control centre.

The notional cost of the laboratory investigations was reduced by 50 % in the study centre compared with increase of 18 % in the control centre.

The cost of laboratory tests per attendance decreased by 46 % in the study centre compared with 15 % reduction in the control ccntre.

The difference between the before and after results for the study centre were statistically significant while it was insignificant for the control centre regarding the total number of tests and the total notional cost.

Important differences were seen in the pattern of test use between the two centres.

Conclusion : The introduction of the direct charge successfully reduced the frequency of ordering and notional cost oflaboratory tests in a primary health care centre.