Impact of Rational Laboratory Practice on Hospital Procedure Costs Based on Evidence-Based Medicine: Case Study In A University Hospital

Abstract

Objective: By integrating the rational laboratory system into hospital processes with evidencebased medicine applications, it is ensured that hospital resources are used more effectively and efficiently by preventing unnecessary test requests and reducing laboratory operation costs. Methods: The data in this qualitative study are the primary data and were obtained through document review and focus group (physician) interviews. The data in question were analyzed comparatively before the Rational Laboratory Application (RLA) (between 01.06.2018- 31.12.2018) and after the RLA (between 01.06.2019-31.12.2019). The universe of the study consists of all the data in the laboratory of Düzce University Health Application and Research Center Hospital (DUHARCH). In this universe, the data evaluated for rational laboratory application constitute the sample of the research. Results: Before the RLA, a total of 446,300 test requests were made in the seven months (in 2018) and the cost of these tests was determined to be 1,591,063 ₺ ($ 330,782.33). After the RLA, a total of 475,585 test requests were made in the seven months (in 2019), and the cost of these tests was determined to be 1,537,903 ₺ ($ 271,235.10). It was found that after RLA, there was a 6.56% increase in the number of examination requests compared to before RLA, but as an amount, costs fell by 3.34% on a ₺ basis and 22% on a $ basis. In the unit-based analysis, it was seen that successful units were surgical, and unsuccessful units were internal units that requested more tests. Conclusions: It was concluded that the rational laboratory system based on evidence-based medicine reduces hospital processing costs, provided that patient safety is protected, so this method can be a tool for more effective and efficient use of hospital resources.

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