Romero Adolfo, Gómez-Salgado Juan, Romero-Arana Adolfo, Ortega-Moreno Mónica, Jódar-Sánchez Francisco, Ruiz-Frutos Carlos
Nursing and Podiatry Department, University Hospital Virgen de la Victoria, Health Sciences School, University of Málaga, IBIMA (Institute of Biomedicine Research, Málaga), Málaga.
Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.
Medicine (Baltimore). 2020 Jul 31;99(31):e21385. doi: 10.1097/MD.0000000000021385.
To perform a cost-error analysis based on a quasi-experimental pre-post study of the preanalytical errors in 2 hospital laboratories. The real cost and theoretical cost are defined as the cost resulting from errors with or without the training intervention. The real impact associated to the training program was estimated, calculated as the total associated to the preanalytical errors cost difference. The costs were measured using Andalusian Public Health Service fees. Cost analysis of an educational intervention presented in a previous study from 2017. Preanalytical errors were detected in the laboratories of the University Hospital Virgen de la Victoria (Málaga, Spain) and in the University Hospital Juan Ramón Jiménez (Huelva, Spain).
The founded errors were divided into blood and urine samples. Univariate sensitivity analysis was used to assess how parameter uncertainty impacted on overall results. Variations of parameters between 0% and 5% were substituted into the base case.
The real impact associated with educational intervention in LAB1 was an increase of &OV0556;16,961.378, and the expected impact was an increase &OV0556;78,745.27 (difference of &OV0556;61,783.9). In LAB2, the real impact in the same period amounted to &OV0556;260,195.37, and the expected impact was &OV0556;193,905.83 (difference of -&OV0556;66,289.54). The results were different in the 2 laboratories, proving the intervention in only one of them to be more effective.
Costs analysis determined that this training intervention can provide saves in the costs, as the effectiveness of the educational sessions in reducing preanalytical errors currently results in a significant decrease of the costs associated with these errors.
基于对两家医院实验室分析前误差的准实验前后研究进行成本误差分析。实际成本和理论成本分别定义为有或无培训干预情况下因误差产生的成本。估计了与培训计划相关的实际影响,计算方法为分析前误差成本差异的总和。成本使用安达卢西亚公共卫生服务费用进行衡量。对2017年之前一项研究中提出的教育干预进行成本分析。在西班牙马拉加的维多利亚圣母大学医院和西班牙韦尔瓦的胡安·拉蒙·希门尼斯大学医院的实验室中检测到分析前误差。
将发现的误差分为血液和尿液样本。使用单变量敏感性分析来评估参数不确定性如何影响总体结果。将参数在0%至5%之间的变化代入基础案例。
LAB1中与教育干预相关的实际影响增加了16,961.378欧元,预期影响增加78,745.27欧元(差异为61,783.9欧元)。在LAB2中,同期的实际影响为260,195.37欧元,预期影响为193,905.83欧元(差异为-66,289.54欧元)。两家实验室的结果不同,证明仅对其中一家进行干预更有效。
成本分析确定,这种培训干预可以节省成本,因为教育课程在减少分析前误差方面的有效性目前导致与这些误差相关的成本大幅降低。