A New Approach to the Costing of Clinical Laboratory Tests

1981 ◽  
Vol 18 (6) ◽  
pp. 330-342 ◽  
Author(s):  
P M G Broughton ◽  
T C Hogan
Keyword(s):  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Indirect Costs ◽  
Working Hours ◽  
Total Annual Cost ◽  
New Approach ◽  
Laboratory Facilities ◽  
The Individual ◽  
The Cost

A method of costing clinical laboratory tests is described which avoids the assumptions and omissions of previous methods and overcomes the basic theoretical difficulty of allocating indirect (overhead) costs, which form the major component. The method develops the concept of a ‘cost per request” to cover indirect costs, which reflect the cost of providing laboratory facilities, and a ‘cost per test” to cover the direct analytical costs of the individual tests done. The direct cost per test was found to vary with the workload, which makes it difficult to predict the effect of changes in demand on expenditure. The Canadian Schedule of Unit Values was found to be an unreliable basis for calculating direct labour costs. Examples are given of the direct and indirect costs of consumables, labour, and capital, and their contribution to the total cost of clinical chemistry tests done either during or outside normal working hours. The total annual cost for each analyte may be a more useful indicator of expenditure than the cost per test.

scholarly journals The significance of indirect costs—application to clinical laboratory test economics using computer facilities

1989 ◽  
Vol 11 (4) ◽  
pp. 174-178
Author(s):  
F. R. Hindriks ◽  
A. Bosman ◽  
P. F. Rademaker
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Indirect Costs ◽  
Cost Structure ◽  
Chemistry Laboratory ◽  
Management Tool ◽  
Structure Model ◽  
Spreadsheet Program ◽  
Clinical Chemistry Laboratory ◽  
The Cost

The significance of indirect costs in the cost price calculation of clinical chemistry laboratory tests by way of the production centres method has been investigated. A cost structure model based on the ‘production centres’ method, the Academisch Ziekenhuis Groningen (AZG) 1-2-3 model, is used for the calculation of cost and cost prices as an add-in tool to the spreadsheet program Lotus 1-2-3. The system specifications of the AZG 1-2-3 cost structure model have been extended with facilities to impute all relevant indirect costs to cost centres by aid of allocation rules, which can be chosen freely. The inference is made that as indirect costs play a more important part in decision-making processes concerning planning and control, the specification of the relation to the cost centres should be determined in a more detailed way. The AZG 1-2-3 cost structure model has therefore been extended in order to increase the significance as a management tool for laboratory management.

scholarly journals The future of clinical chemistry and its role in healthcare: a report of the Athena Society

1996 ◽  
Vol 42 (1) ◽  
pp. 96-101 ◽  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Analytical Techniques ◽  
Leadership Role ◽  
Professional Organizations ◽  
Clinical Laboratory Science ◽  
Disciplinary Expertise ◽  
New Type ◽  
The Common ◽  
The Individual

Abstract Given the omnipresent cost-containment environment in which clinical chemists now work, they must adapt to a host of changed conditions and new pressures. Much of the onus of adapting is on the individual who must assume a different attitude to his or her work. The American Association for Clinical Chemistry can, and should, take a leadership role in developing a new type of laboratory director by working with other professional organizations in the clinical laboratory field to create training programs and retraining programs for existing clinical laboratory scientists, which will equip them for broader scientific and managerial responsibilities than hitherto. AACC needs to develop alliances with its sister organizations so that the common issues are addressed collectively rather than competitively. The scope of clinical chemistry must expand into areas other than traditional clinical chemistry, e.g., microbiology, immunology, certain aspects of hematology (including coagulation), and even aspects of blood banking. The former clinical chemist needs to become a clinical laboratory scientist and promote him- or herself as having cross-disciplinary expertise in analytical techniques and automation, which are the common threads linking all branches of clinical laboratory science.

scholarly journals Proteomics: A New Diagnostic Frontier

2006 ◽  
Vol 52 (7) ◽  
pp. 1218-1222 ◽  
Author(s):  
Glen L Hortin ◽  
Saeed A Jortani ◽  
James C Ritchie ◽  
Roland Valdes ◽  
Daniel W Chan
Keyword(s):  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Biological Fluids ◽  
Great Promise ◽  
Structural Variations ◽  
Protein Fragments ◽  
Recent Conference ◽  
Complete Set ◽  
Source Of Information

Abstract Background: Analysis of proteins has been an integral part of the field of clinical chemistry for decades. Recent advances in technology and complete identification of the human genome sequence have opened up new opportunities for analysis of proteins for clinical diagnostic purposes. Methods: Content of a recent conference of proteomics is summarized. Results: New analytical methods allow the simultaneous analysis of a large number of proteins in biological fluids such as serum and plasma, offering partial views of the complete set of proteins or proteome. Plasma presents many analytical challenges, such as the complexity of components, predominance of a few major components, and the large concentration range of components, but the number of proteins that can be detected in plasma has expanded dramatically from hundreds to thousands. At the same time, there is increased capability to detect structural variations of proteins. Recent studies also identified the presence of complex sets of small protein fragments in plasma. This set of protein fragments, the fragmentome or peptidome, is potentially a rich source of information about physiologic and disease processes. Conclusions: Advances in proteomics offer great promise for the discovery of markers that might serve as the basis for new clinical laboratory tests. There are many challenges, however, in the translation of newly discovered markers into clinical laboratory tests.

scholarly journals MODULARANALYTICS: A New Approach to Automation in the Clinical Laboratory

2005 ◽  
Vol 2005 (1) ◽  
pp. 8-25 ◽  
Author(s):  
Gary L. Horowitz ◽  
Zahur Zaman ◽  
Norbert J. C. Blanckaert ◽  
Daniel W. Chan ◽  
Jeffrey A. Dubois ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Control Unit ◽  
Turnaround Time ◽  
Chemistry Laboratory ◽  
New Approach ◽  
Typical Sample ◽  
Clinical Chemistry Laboratory ◽  
Carry Over ◽  
Roche Diagnostics

MODULARANALYTICS(Roche Diagnostics) (MODULARANALYTICS, Elecsys and Cobas Integra are trademarks of a member of the Roche Group) represents a new approach to automation for the clinical chemistry laboratory. It consists of a control unit, a core unit with a bidirectional multitrack rack transportation system, and three distinct kinds of analytical modules: an ISE module, a P800 module (44 photometric tests, throughput of up to 800 tests/h), and a D2400 module (16 photometric tests, throughput up to 2400 tests/h). MODULARANALYTICSallows customised configurations for various laboratory workloads. The performance and practicability of MODULARANALYTICSwere evaluated in an international multicentre study at 16 sites. Studies included precision, accuracy, analytical range, carry-over, and workflow assessment. More than 700 000 results were obtained during the course of the study. Median between-day CVs were typically less than 3% for clinical chemistries and less than 6% for homogeneous immunoassays. Median recoveries for nearly all standardised reference materials were within 5% of assigned values. Method comparisons versus current existing routine instrumentation were clinically acceptable in all cases. During the workflow studies, the work from three to four single workstations was transferred to MODULARANALYTICS, which offered over 100 possible methods, with reduction in sample splitting, handling errors, and turnaround time. Typical sample processing time on MODULARANALYTICSwas less than 30 minutes, an improvement from the current laboratory systems. By combining multiple analytic units in flexible ways, MODULARANALYTICSmet diverse laboratory needs and offered improvement in workflow over current laboratory situations. It increased overall efficiency while maintaining (or improving) quality.

Estimation of the cost of MS in Europe: Extrapolations from a multinational cost study

2007 ◽  
Vol 13 (8) ◽  
pp. 1054-1064 ◽  
Author(s):  
P. Sobocki ◽  
M. Pugliatti ◽  
K. Lauer ◽  
G. Kobelt
Keyword(s):  
Annual Cost ◽  
Indirect Costs ◽  
Epidemiological Data ◽  
Cost Data ◽  
Primary Data ◽  
Total Annual Cost ◽  
Cost Study ◽  
Total Cost ◽  
Prevalence Estimates ◽  
The Cost

The present study aims at estimating the total cost of MS in Europe based on actual cost data from nine countries and published epidemiological evidence. The epidemiological data are reported as 12 months prevalence estimates and cost data calculated as annual cost per patient at given levels of disease severity. Cost data are extrapolated to the rest of Europe based on a model, using economic indexes adjusting for price level differences in different sectors between countries. The aggregated annual cost estimates are presented in Euro for 2005. In 28 European countries with a population of 466 million, an estimated 380 000 individuals are affected by MS. The total annual cost of MS in Europe is estimated at 12.5 billion in year 2005, corresponding to a cost of 27 per European inhabitant. Direct costs represent slightly more than half of the total cost (6.0 billion). Informal care is estimated at 3.2 billion, and indirect costs due to morbidity at 3.2 billion. Thus, the largest component of costs is found outside the formal health care sector. Although our model appears to predict costs reasonably well, when comparing to previous national studies not included in the estimates, there are considerable uncertainties when extrapolating cost data across countries even within Europe. These weaknesses can only be overcome by collecting primary data. Multiple Sclerosis 2007; 13: 1054—1064. http://msj.sagepub.com

Diagnostic performances of clinical laboratory tests using Triton X-100 to reduce the biohazard associated with routine testing of Ebola virus-infected patients

2015 ◽  
Vol 53 (12) ◽  
Author(s):  
Massimo Tempestilli ◽  
Luigia Pucci ◽  
Stefania Notari ◽  
Antonino Di Caro ◽  
Concetta Castilletti ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Ebola Virus ◽  
Clinical Laboratory ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
Clinical Chemistry ◽  
Chemical Agent ◽  
Enveloped Virus ◽  
Before And After ◽  
Triton X

AbstractEbola virus, an enveloped virus, is the cause of the largest and most complex Ebola virus disease (EVD) outbreak in West Africa. Blood or body fluids of an infected person may represent a biohazard to laboratory workers. Laboratory tests of virus containing specimens should be conducted in referral centres at biosafety level 4, but based on the severity of clinical symptoms, basic laboratories might be required to execute urgent tests for patients suspected of EVD. The aim of this work was to compare the analytical performances of laboratory tests when Triton X-100, a chemical agent able to inactivate other enveloped viruses, was added to specimens.Results of clinical chemistry, coagulation and haematology parameters on samples before and after the addition of 0.1% (final concentration) of Triton X-100 and 1 h of incubation at room temperature were compared.Overall, results showed very good agreement by all statistical analyses. Triton X-100 at 0.1% did not significantly affect the results for the majority of the analytes tested.Triton X-100 at 0.1% can be used to reduce the biohazard in performing laboratory tests on samples from patients with EVD without affecting clinical decisions.

scholarly journals The Cost of Chronic Wounds in Argentina: An Estimation of the Burden in a Public Hospital

2019 ◽  
Author(s):  
Romina Chavez-Jara ◽  
Nicolas Cerusico ◽  
Maria Lazarte ◽  
Carla Cabrera ◽  
Andrea Herrera Bruno ◽  
...  
Keyword(s):  
Cost Estimation ◽  
Laboratory Tests ◽  
Public Hospital ◽  
Chronic Wounds ◽  
Cost Information ◽  
Male And Female ◽  
New Public Health ◽  
The Mean ◽  
The Individual ◽  
The Cost

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system.  However, there is a lack of information about the cost of CLLU in Argentina.Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests, in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7,224 and the number of inpatient was 359. The mean age for male and female outpatient consultations was 59.53(±13.06) years and 59.04(±10.93), respectively. For CLLU male and female inpatient, the mean age was 63.9(±10.4) years and 54.5(±8.6) years, respectively. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$4,053.65 per inpatient and US$3,589.24 per outpatient. Conclusion: Cost information allows new public health policies to reduce socioeconomic burden due to CLLU.

scholarly journals Project Scheduling Analysis Using the Precedence Diagram Method (PDM) Case Study: Surabaya’s City Outer East Ring Road Construction Project (Segment 1)

2021 ◽  
Vol 1 (2) ◽  
pp. 53-61
Author(s):  
Syahrur Romadhona ◽  
Fredy Kurniawan ◽  
Julistyana Tistogondo
Keyword(s):  
Critical Path ◽  
Road Construction ◽  
Indirect Costs ◽  
Working Hours ◽  
Concrete Surface ◽  
Diagram Method ◽  
Ring Road ◽  
The Difference ◽  
The Cost

The project acceleration by the Crash Program is one of the ways that is often used to make time and cost efficiency on an ongoing project. Acceleration of project completion time will affect the efficiency of equipment and labor productivity. In the case study of the Surabaya Outer East Ring Road Project Construction Segment 1, a project that has the potential to be accelerated is discussed in order to obtain efficiency values in terms of time and cost, Project acceleration by means of the Crash Program using the Precedence Diagram Method (PDM) method to determine the value of efficiency. This project uses resources, in this research the software used is Microsoft Project 2016. The research method used is to design network planning, find the critical path for each job, determine the work that has the potential to be accelerated, calculate the crash cost in additional working hours. and work shifts, calculating direct costs and indirect costs for each activity that changes due to changes in the duration of implementation, calculating the cost slope. Application of the Crash Program in the work of Asphalt Concrete Surface Layers (AC) thick 5 cm in the project will have an impact on increasing the time efficiency previously planned from 180 working days to 175 working days and efficiency with the difference in project costs of Rp. 18.313.935,8 with a ratio of 0,997 between the PDM method compared to the cost of the contract value calculated using the crashing project method.

scholarly journals Lead - a preanalytical/analytical variable in clinical chemistry

2014 ◽  
Vol 12 (1) ◽  
pp. 65-76
Author(s):  
Ivana Rasic-Misic ◽  
Emilija Pecev-Marinkovic
Keyword(s):  
Lead Poisoning ◽  
Laboratory Tests ◽  
Review Paper ◽  
Clinical Laboratory ◽  
Clinical Chemistry ◽  
Clinical Chemical ◽  
Analytical Variable ◽  
Lead Intake ◽  
Proper Interpretation

Lead is one of the most studied clinically important metals due its high toxicity and a high number of workers exposed to it. The interest toward Pb is elevated by the fact that children are especially susceptible to lead poisoning. Research regarding lead poisoning requires a complex, multi-disciplinary (clinical medical and clinical chemical) approach. Monitoring human exposure to lead (intake, i.e. poisoning) may be achieved by quantification of Pb in tissues and body fluids. For that reason, a number of accurate and reliable analytical methods for the determination of Pb (analytical/preanalytical variable) were developed. An objective of this review paper is to provide key information necessary for proper interpretation of results of lead related clinical/laboratory tests.

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