Dollar Cost per Positive Test for Automated Multiphasic Screening

The costs to identify a clinically important test by an automated multiphasic screening program provide useful information in planning for a specified target population. When 44,663 multiphasic examinations performed in a 12-month period were analyzed, the most costly procedure was found to be the detection of breast cancer ($408.00 per positive mammogram), even when it was limited to women over the age of 47, and the least expensive was hearing impairment ($1.55 per positive audiogram). All other tests ranged between these extremes, usually varying with age and sex of the examinees. These unit costs are critically related to a multiphasic laboratory load of 500 patients per week. The results clearly show how the prevalence of an abnormal test depends on the specific population examined, especially as related to its age–sex composition.