Open AccessThyroid Hormone Tests Ordering Practice and Cost-Effectiveness in Samples Referred to International Clinical Laboratories from Addis Ababa Health Facilities
Author(s) -
Kifle Tilahun,
Meaza Demissie,
Tamrat Bekele,
Mesfin Nigussie,
H M Damen,
Mariam Mariam
Publication year - 2020
Publication title -
ethiopian journal of health sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.479
H-Index - 20
eISSN - 2413-7170
pISSN - 1029-1857
DOI - 10.4314/ejhs.v30i3.5
Subject(s) - medicine , thyroid function tests , guideline , thyroid , thyroid function , pediatrics , public health , thyroid stimulating hormone , thyroid disorder , thyroid disease , environmental health , family medicine , pathology
BACKGROUND: Thyroid dysfunction accounts for majority of endocrine disorders. In sub-Saharan Africa Graves’ disease and hypothyroidism have accounted for 13.1% and 8.8% while the burden of thyroid disorder has ranged from 6.18 to47.34% among countries in the Arab world. The cost for a primary thyroid test done to evaluate the gland function constituted a large proportion of the public health budget. For instance, 10 million thyroid functions have been done each year by laboratories which cost 30 million UK pounds, and they represent 8% of laboratory charge in the US. When a TSH-only protocol (guideline) was used, 95% of the requests were sufficient for diagnosis without requiring further tests, thereby resulting in 50% savings on FT4 reagent and reducing the annual TFT reagent cost by 25%. This is an original study, and its objective was to assess the ordering pattern of TSH tests and their cost-effectiveness in patients’ samples referred to ICL from Addis Ababa health facilities between July2015 to June 2016METHOD: An institution-based cross-sectional study design was utilized to study the ordering pattern of thyroid function tests using one-year retrospective data from ICL.RESULTS: Thyroid profiles were ordered more frequently (49.5%) compared to TSH only (24.3%). An additional 2625.70 USD was paid by patients for individual components in the profile tests that turned out normal.CONCLUSION: Guidelines advocate TSH as the initial test for thyroid dysfunction, but the use of a combination of tests is more common.