1. Cost-analysis project: Daily CBC
Hoa Nguyen, MD
PGY2
April 2017

2. Background
Daily CBCs are often ordered to monitor patients though at times not necessarily indicated

3. The Plan Define indications for CBC (with and without differentials)
Identify cost of CBC at UCI
Monitor the CBC ordering practices of one UCI ward team over one week
Calculate the number of inappropriately ordered CBC and associated costs

4. Indications for CBC On admission New signs or symptoms of infection
New signs of symptoms of anemia
Active GI bleeding
Monitoring thrombocytopenia
Contraindications:
Patient without above criteria and daily monitoring in hemodynamically stable patients

5. Costs
CBC $54
CBC with differential: $65

6. The Results Day Number of CBC/CBC with diffs ordered
Number not indicated
Excess cost 1 16 5
~$300 2 14 6
~$360 3 18 4
~$240 15 10 7 17
~$420

7. The Results Total excess cost in 1 week: ~$2004
Projected excess cost in 1 year for 1 team:~$104,208
Projected excess cost in 1 year for all medicine teams: ~$625,248

8. Conclusions There is a large amount of excess ordering of CBCs
This results in high excess cost especially if projected to a year and even more when considering all medicine teams
There should be more care in ordering CBCs and only ordering for indicated reasons.