Economic Analysis of Requests for Laboratory Tests in Primary Health Care Centers

Abstract

Introduction:Operation of the Primary health care center and Medical-biochemical laboratories depends on the number of performed laboratory tests. The number of unnecessary tests significantly affect the operation of health institutions.Material and methods:We analyzed the 1000 requests for laboratory tests at the Primary Health Care Centre in Gracanica from primary care units. Based on the requests for laboratory diagnostics advisable diagnoses from primary health care unit in the Primary Health Care Center (PHC) we made an economic analysis of the total required laboratory tests in the requests for laboratory diagnosis. Incorporating the economic analysis of laboratory tests in requests for laboratory diagnosis by doctors in primary health care (PHC) and the economic analysis of laboratory tests by the disease in primary health care.Results:The economic value of 5333 laboratory tests was 84 312 points (1 point is 0.80 KM). Of the total value of the index score requirements of GPs are 44, 1%, the requirement of family doctors account for 40% and requirements of other specialists make up 15, 9%.. Discussion: In the requests of the PHC units for laboratory tests are required all levels of services: urine, CBC, SE, glucose, bilirubine, ALT, AST, AF, CK, cholesterol, HDL chol., triglicerdes, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requests are the most common laboratory tests: urine, CBC, blood glucose, cholesterol, triglycerides, aminotransferases, creatinine, urea. The doctors in family practice most often requested: blood glucose, urine, CBC, SE, TGL. , Chol., ALT, AST, creatinine and urea. General practitioners were demanding more cholesterol and triglycerides, and family medicine doctors were demanding less cholesterol and triglycerides and more often CRP, fibrinogen, ALT, AST, what from the level of economic cost analysis rises the issue whether this was justified?

The Role and Impact of Reference Laboratories in the Primary Health Care System

“…According to the Recommendation of the Committee of Ministers to Member States on Biomedical Research (Rec 4, 2006) of the Council of Europe, "medical biochemistry laboratories provide vital support for diagnostics, treatment and follow-up care in the healthcare system" [4,5]. In the Laboratory Recommendation for the Diagnosis of Synthetic Function of the Liver publication we read: "The main tasks of medical diagnostic laboratories are to assess patient health status rapidly and accurately, the control of drug treatment and monitoring of the progression of the patient's disease.…”

“…Screening laboratory tests are used to detect disease and risk factors. Exploratory laboratory tests are used in following and diagnosing acquired and congenital diseases in patients predicted with one illness [3,4]. The objectives of the follow-up testing are: "confirmation of the diagnosis of the disease, confirmation of the severity, prognosis, determination of the effectiveness of the therapy, recognition of the appearance of the side effects of the medical treatment", the collection of the followup data for patients with known disease, the monitoring or the effectiveness of the treatment.6The fundamental purpose of the laboratory tests is to obtain data that will constitute a pool of results to be verified subsequently and will generate feedback to clinicians and other professionals.…”

“…Analyzing the molecular networks could be personalized future therapeutic approach and to design russian arm phase II studies for repurposing the new and old molecularly validated molecules. The number of laboratory analyses ordered by general practitioners significantly impacted the laboratory's operations [4]. Since unnecessary laboratory analyses waste time and resources, as well as increase patient anxiety, the need to minimize their number in family medicine centers is clear.…”

A Novel Earwax Method to Measure Acute and Chronic Glucose Levels

“…Blood samples may be associated with some side effects, such as bleeding, infection, and local pain. Nonetheless, the glycemic level is still the most requested lab test in primary health care centers in several countries [ 24 , 25 ]. The glycemia represents the third largest lab cost for some health systems [ 21 ].…”

Defining the Optimal Size of Medical Laboratories at the Primary Level of Health Care with Data Envelopment Analysis: Defining the Efficiency of Medical Laboratories

“…Laboratories at the primary level of medical care perform basic laboratory testing for diagnostic pur- (8,9,10). Financial rationalization in laboratory medicine can be achieved through the consolidation, centralization and regionalization of laboratory services; furthermore, the importance of laboratory automation is highlighted in connection with the cost-effectiveness of laboratories (10,11,12,13).…”