Herráez Carrera O, Huertas Vaquero M, Asencio Egea M A, Gaitán Pitera J, Carranza González R
Oscar Herráez Carrera, Servicio de Análisis Clínicos. Unidad de Calidad. Hospital General La Mancha Centro, Avenida de la Constitución, 3 ; 13.600 Alcázar de San Juan (Ciudad Real) Spain.
Rev Esp Quimioter. 2019 Feb;32(1):73-77. Epub 2019 Jan 9.
It is becoming increasingly necessary to automatize screening of urine samples to culture at Microbiology laboratories. Our objective was to estimate the budget threshold from which the Alfred 60/AST device would be profitable for our hospital.
Cost minimization study by decision trees, carried out in a General Hospital. The cost of traditional urine culture and urine processing using Alfred-60/AST were compared. Traditional processing involves the culture of all urine specimens received onto blood and MacConkey agar, and identification of every microorganism isolated by Vitek-2 system. The autoanalyzer would only inoculate the positive urines onto a chromogenic media, directly identifying the Escherichia coli isolates.
The variables with the greatest economic impact in the model were the probability of obtaining a positive culture, the prevalence of E. coli in the urine cultures and the cost per sample using Alfred-60/AST. The multivariate sensitivity analysis showed that the model was solid. The bivariate sensitivity analysis showed that the model is suceptible to cost modification, mainly of the automatic device. At a threshold value of 1.40 euros/determination, the automatic processing would decrease the annual costs in 2,879 euros.
The introduction of the Alfred-60/AST device in our laboratory at 1.40 euros/determination would reduce urine processing workload, saving time and costs.
微生物实验室对尿液样本进行培养筛查的自动化变得越来越必要。我们的目标是估算出阿尔弗雷德60/AST设备对我院而言实现盈利的预算阈值。
在一家综合医院通过决策树进行成本最小化研究。比较了使用阿尔弗雷德-60/AST进行传统尿液培养和尿液处理的成本。传统处理方法是将所有收到的尿液标本接种到血琼脂和麦康凯琼脂上进行培养，并通过Vitek-2系统对分离出的每种微生物进行鉴定。自动分析仪只会将阳性尿液接种到显色培养基上，直接鉴定出大肠杆菌分离株。
模型中对经济影响最大的变量是培养结果呈阳性的概率、尿液培养中大肠杆菌的患病率以及使用阿尔弗雷德-60/AST的每份样本成本。多变量敏感性分析表明该模型是可靠的。双变量敏感性分析表明该模型易受成本变化的影响，主要是自动设备的成本。当测定阈值为1.40欧元时，自动处理将使年度成本降低2879欧元。
在我们实验室以1.40欧元/测定的价格引入阿尔弗雷德-60/AST设备将减少尿液处理工作量，节省时间和成本。
