Delay in receiving lab test results increases the costs of treating an episode of care for treating urinary tract infections.

Abstract

Aims: To provide the first national study examining the impact on the health care costs of treating an episode of urinary tract infection as a function of the time delay in receiving antimicrobial susceptibility test results.

Methods: We used a nationally representative data set of privately insured adults and dependents. Our retrospective analysis included those receiving a urine bacteria test and susceptibility testing and ultimately diagnosed with a urinary tract infection. Using regression analysis, we estimate episode of care-based treatment costs associated with each day of delay in receiving susceptibility test results controlling for patient age, gender, and number of comorbid conditions.

Results: Delays in receiving test results that allow for filling a prescription or a diagnosis increase health plan treatment costs. The analysis looked at patients with a susceptibility test and an ultimate diagnosis of urinary tract infection. We examined the days between the test and two outcomes, the diagnosis and the prescription filled. Even 1 day of delay added over $1,600 (2022 US dollars) in health plan spending to treat the condition. These additional costs were traced to increased hospitalizations for the condition for each day of delay. Delays in prescriptions filled added the most to treatment costs. Receiving test results on the day of test could reduce treatment costs by 40%.

Limitations: There are a whole range of bacterial tests. The analysis focused on only one - a urine bacterial and susceptibility culture test - and was limited to patients ultimately diagnosed with urinary tract infection.

Conclusions: The analysis provides the first national estimates of the increased costs of treating urinary tract infections due to delays in receiving test results. Slow turnaround times in receiving test results for bacterial infections increase hospitalizations and health plan and employer spending for treating infections. We need new technologies that allow for rapid results for these tests.