Measures of Reducing the Burden of Health Care Costs by Rational Usage of Laboratory Tests
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Date
2020
Authors
Marchenko, Y.
Akhmetove, R.
Journal Title
Journal ISSN
Volume Title
Publisher
International conference "MODERN PERSPECTIVES FOR BIOMEDICAL SCIENCES: FROM BENCH TO BEDSIDE”; National Laboratory Astana
Abstract
Introduction: Every year manufacturers offer new tests, postulating that it will improve the outcomes
of treatment. That results that laboratories have to face an increasing workload combined with a reduction
of resources. Implementing strategies to reduce the use of unnecessary and redundant tests
is an essential tool to manage increasing health care costs. In the study, it was determined to look at
the effectiveness of using laboratory tests performed by an express-laboratory, because of the costs of
maintenance express-laboratories higher than lab for routine analyses.
Methods: The quarterly report of the Center of Laboratory Medicine (CLM - a centralized laboratory) for
the first quart of 2019, the Laboratory Information System and Hospital Information System were used
to get data. Data were processed by Microsoft Excel.
Results: The express-laboratory department performed 21% of the total number of laboratory tests
performed by the CLM. The level of the workload of the personnel was examined by assessing TAT. The
degree of demand for laboratory data was determined by evaluating the period from the moment of
results preparedness to the moment it was viewed by clinicians. TAT was calculated for 4 phases of time
and data shows that in 2 phases from 4 am to 16 pm the percentage of samples were processed with an
unacceptable range of TAT. There were 81929 analytical requests made with mark “cito”, among them
59070 (72,1%) were visualized by clinicians during 30 minutes after readiness, 21465 (26,2%) were visualized
in more than in 4h and 1392(1,7%) were not visualized.
Conclusions: As it is seen from the data the staff in the express-laboratory is overloaded in some period
and cannot reach the established range of TAT for 31% of tests. However, the findings show that not all
results are visualized by clinicians. The not visualized reports mean performing an invasive technique
that it will not contribute to benefit the patient. Thus, it is necessary to make more strict regulatory for
analytical requests in express-laboratory by updating medical protocols for critical conditions and harmonizing
the panel of tests for them as well as by implementing point of care tests.
Description
Keywords
laboratory test, costs of laboratory test, laboratory workload, TAT, Research Subject Categories::MEDICINE