Activity-based cost analysis of laboratory tests in clinical chemistry
-
Baptist Declerck
,
Mathijs Swaak
Abstract
Ojectives
Since health care budgets are limited and must be allocated efficiently, there is an economic pressure to reduce the costs of health care interventions. This study aims to investigate the cost of testing within a Clinical Chemistry laboratory.
Methods
This study was conducted in the Clinical Chemistry laboratory of the University Hospital UZ Brussel, Belgium, in which 156 tests were included and an average cost per test was calculated for the year 2018. Activity-based costing (ABC) was applied, using a top-down perspective. Costs were first allocated to different activity centers and subsequently to different tests. Number of tests, parameters, analyzers and time estimates were used as activity cost drivers.
Results
The blood glucose test on the point-of-care testing (POCT) analyzer Accu Chek Inform II had the lowest unit cost (€0.92). The determination of methanol, ethanol and isopropanol on the GC-FID (7820A) is the test with the highest unit cost (€129.42). In terms of average cost per test per activity center, core laboratory (€3.37) scored lowest, followed consecutively by POCT (€3.49), diabetes (€22.09), toxicology (€31.52), metabolic disorder (€41.53) and cystic fibrosis (€86.02). The cost per test was mainly determined by staff (57%), costs of support services (23%) and reagents (14%).
Conclusions
High-volume and automated tests have lower unit costs, as is the case with the core laboratory. ABC provides the ability to identify high average cost tests that can benefit from optimizations, such as focusing on automation or outsourcing low-volume tests that can benefit from economies of scale.
Acknowledgments
This study was part of a thesis in Master of Health Care Management and Policy at the KU Leuven University. We thank the management of UZ Brussel for allowing this study to be carried out and all those involved at UZ Brussel who participated in this study.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: Not applicable.
References
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