Information asymmetry in the Kenyan medical laboratory sector

Abstract

Background Important information about medical laboratory providers is not readily available to all patients, clinicians nor regulators in Kenya. This study was conducted as part of a wider project aiming to improve access to high quality diagnostics by addressing information asymmetries in the Kenyan market for laboratory services. Objectives The purpose of this study was to: 1) Gather pricing information for 49 common laboratory tests from medical laboratories in Nairobi, Kenya, noting where these prices were publicly available or withheld. 2) Assess patients’ knowledge of testing information including: turnaround time, price, and test availability. Method This was a cross-sectional study where a mystery caller approach was used to survey 49 tests for turnaround time, price, and availability across 13 laboratories selected purposively. The mystery shopper survey was complemented by 251 patient exit interviews at two Kenyan hospitals to understand whether patients seeking laboratory tests in Nairobi had access to such information. All 251 patients were selected by convenience sampling. Results We noted that 85% of the private laboratories did not disclose test prices and turnaround times to their patients. There was a wide range of prices on several key tests, with private in-facility laboratories charging an average test price of 468% of the average test price in public laboratories across all the 49 tests. We also found that many patients lacked key information regarding the tests they needed: 65% did not know the purpose of the test while 41% did not know the test price at all. Conclusion Under the current system, patients have limited access to information regarding the key criteria required to make a rational decision. This has a significant impact on the quality, price, and turnaround time (TAT) offered by the medical laboratories that operate in this dysfunctional market.

Reporting of diagnostic and laboratory tests by general hospitals as an indication of access to diagnostic laboratory services in Kenya

“…laboratory tests [27]. Such movements are costly, time consuming for the patients and unnecessarily increase the turnaround time, consequently resulting in delayed care [28].…”

Influence of E-consultation on the Intention of First-Visit Patients to Select Medical Services: Results of a Scenario Survey

“…However, patients face insufficiency of medical information collection. On the one hand, the information barrier in hospitals is apparent, which makes it difficult for patients to obtain adequate information [ 18 ]. On the other hand, the health literacy of patients is limited, and so medical information cannot be the basis of effective decision making, even in the internet age of information explosion [ 19 ].…”