Abstract
We estimated direct medical and nonmedical costs associated with a false diagnosis of tuberculosis (TB) caused by laboratory cross-contamination of Mycobacterium tuberculosis cultures in Massachusetts in 1998 and 1999. For three patients who received misdiagnoses of active TB disease on the basis of laboratory cross-contamination, the costs totaled U.S. dollars 32618. Of the total, 97% was attributed to the public sector (local and state health departments, public health hospital and laboratory, and county and state correctional facilities); 3% to the private sector (physicians, hospitals, and laboratories); and <1% to the patient. Hospitalizations and inpatient tests, procedures, and TB medications accounted for 69% of costs, and outpatient TB medications accounted for 18%. The average cost per patient was dollars 10873 (range, dollars 1033-dollars 21306). Reducing laboratory cross-contamination and quickly identifying patients with cross-contaminated cultures can prevent unnecessary and potentially dangerous treatment regimens and anguish for the patient and financial burden to the health-care system.
Highlights
We estimated direct medical and nonmedical costs associated with a false diagnosis of tuberculosis (TB) caused by laboratory cross-contamination of Mycobacterium tuberculosis cultures in Massachusetts in 1998 and 1999
We estimated direct medical and nonmedical costs for three patients whose misdiagnoses of active TB disease resulted from laboratory cross-contamination of Mycobacterium tuberculosis cultures
Two thirds of patients with false-positive cultures are treated for active TB disease [4] and may undergo unnecessary, potentially toxic anti-TB therapy
Summary
We estimated direct medical and nonmedical costs associated with a false diagnosis of tuberculosis (TB) caused by laboratory cross-contamination of Mycobacterium tuberculosis cultures in Massachusetts in 1998 and 1999. For three patients who received misdiagnoses of active TB disease on the basis of laboratory cross-contamination, the costs totaled U.S.$32,618. We estimated direct medical and nonmedical costs for three patients whose misdiagnoses of active TB disease resulted from laboratory cross-contamination of Mycobacterium tuberculosis cultures. Dunlap et al report that if persons who receive misdiagnoses resulting from laboratory cross-contamination were treated as TB casepatients with contact investigations and 6 months of directly observed therapy, the costs to the health-care system would be $2,500 per patient [12] in 1993 U.S dollars, or $3,111 in 1999 dollars, when the Medical Care component of the Consumer Price Index is used to convert 1993 dollars to 1999 dollars
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