G Priyadharshini, Ramalingam Karthikeyan, Ramani Pratibha, Nallaswamy Deepak
Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Oct 7;16(10):e70997. doi: 10.7759/cureus.70997. eCollection 2024 Oct.
Background Internal audits are essential tools for enhancing the operational efficiency, quality, and effectiveness of healthcare departments. Audits enable the departments and laboratories to meet the changing needs of the healthcare environment by giving a detailed picture of the department's operations and highlighting areas for possible growth and development. Aims and objectives This study focuses on the biopsies received in the Oral Pathology Department at Saveetha Dental College, aiming to evaluate biopsy trends, financial performance, and resource utilization over one year. Materials and methods The oral pathology department audit covered the period from 1st April 2023 to 31st March 2024. The institutional human ethical committee and scientific review board approved the retrospective audit. It involved a comprehensive analysis of biopsy data, financial records, and material usage. Data on different biopsy types (excisional, incisional, frozen sections), immunohistochemistry, cytology, and special stains were collected and analyzed across four quarters. Financial performance was assessed by comparing total income and expenses, while resource utilization was examined through the use of histopathological blocks and other consumables. Statistical analysis (chi-square) was performed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). A P-value less than 0.05 was considered statistically significant. Results We received 1100 cases during the study period. Excisional biopsies were the most common, with 474 (43.09%) cases, followed by incisional biopsies with a total of 432 (39.27%). Out of total cases of 1100, the second quarter (July-September 2023) had the highest case volume of 305 (27.72%), while the third quarter (October-December 2023) recorded the lowest of 250 (22.72%) cases. A financial audit revealed an annual deficit of ₹1,03,321 primarily due to higher expenses towards laboratory reagents. The overall expense incurred per case was ₹448.5. Tissue blocks cost ₹85.23 per case (19.00%) of the average cost per case. The chi-square test analysis was insignificant among the different types of biopsies and the reagent consumption across the four quarters. Conclusion The audit identified critical areas for improvement in both clinical workload and financial management. High volumes of biopsies, but net financial deficits highlight the need for better cost management and resource utilization strategies to maintain sustainability without compromising diagnostic quality.
背景 内部审计是提高医疗部门运营效率、质量和有效性的重要工具。审计通过详细描述部门运营情况并突出可能的增长和发展领域，使各部门和实验室能够满足医疗环境不断变化的需求。
目的 本研究聚焦于萨维莎牙科学院口腔病理科接收的活检病例，旨在评估一年中的活检趋势、财务表现和资源利用情况。
材料与方法 口腔病理科审计涵盖2023年4月1日至2024年3月31日期间。机构人类伦理委员会和科学审查委员会批准了此次回顾性审计。审计涉及对活检数据、财务记录和材料使用情况的全面分析。收集并分析了四个季度不同活检类型（切除活检、切开活检、冰冻切片）、免疫组化、细胞学和特殊染色的数据。通过比较总收入和支出评估财务表现，通过使用组织病理学切片块和其他耗材来检查资源利用情况。使用IBM SPSS Statistics for Windows 23版（2015年发布；IBM公司，美国纽约州阿蒙克）进行统计分析（卡方检验）。P值小于0.05被认为具有统计学意义。
结果 在研究期间我们共接收了1100例病例。切除活检最为常见，有474例（43.09%），其次是切开活检，共有432例（39.27%）。在1100例总病例中，第二季度（2023年7月至9月）病例量最高，为305例（27.72%），而第三季度（2023年10月至12月）病例量最低，为250例（22.72%）。财务审计显示年度亏损103321卢比，主要原因是实验室试剂费用较高。每例病例的总费用为448.5卢比。组织切片块每例病例成本为85.23卢比（占每例病例平均成本的19.00%）。不同类型活检与四个季度试剂消耗之间的卡方检验分析无显著差异。
结论 审计确定了临床工作量和财务管理方面的关键改进领域。活检数量众多，但净财务亏损凸显了需要更好的成本管理和资源利用策略，以在不影响诊断质量的情况下维持可持续性。
