Cost Analysis in the Clinical Chemistry Laboratory in the Era of Automation: Our Experience

Abstract

Aim: In the era of automation, the modalities available for analysis of samples for a clinical chemistry laboratory include both wet chemistry and dry chemistry analyzers. Wet chemistry systems are routinely used in small to large clinical chemistry laboratories whereas dry chemistry analyzers are restricted to large laboratories. Cost analysis is a system that is used for providing financial information to make financial projections. Aim of the study was to compare the cost analysis of wet chemistry and a dry chemistry analyzer. Materials and methods: Apart from the cost of the basic kits, a large number of controls, calibrators, consumables, and fluids are procured to run the various tests in the laboratories. A cost analysis of the wet chemistry analyzer and the dry chemistry analyzer available with us was performed to compare both the systems. Results: The cost per test (CPT) of the parameters on the wet chemistry analyzer was lower as compared to the dry chemistry analyzer. On factoring the cost of controls, calibrators, tubings, accessories and other consumables for both the systems, a figure of ` 8.91 as the cost of consumables per test for the wet chemistry analyzers and ` 0.40 for the dry chemistry analyzer was reached. On the further calculation of the cost per reproducible test (CPRT), it was seen that the wet chemistry analyzer had CPRT of ` 26.43 and the dry chemistry analyzer had `23.5. Conclusion:The results point towards the dry chemistry analyzer as being cheaper to a wet chemistry analyzer if the workload of samples being analyzed on them is high. Clinical importance: A thorough cost analysis is imperative to be done for any clinical chemistry laboratory to determine the cost-effectiveness of a system so that an informed decision can be made to incorporate new methods if required.

Agreement of results between dry and wet chemistry system for common clinical chemistry parameters

“…However, when considering high specific workloads, the cost per reporting test (CPRT) of the dry chemistry system was found to be lower than that of the wet chemistry system. 5 Beside the cost factor, dry chemistry analyzer is also believed to enhance performance in external quality assurance schemes (EQAS) as observed by Mukherjee et al 12 The high level of correlation and agreement observed suggests that both systems can provide reliable results. However, it is important to consider the specific parameters and limitations of each system when interpreting the results.…”

“…Tests run on wet chemistry analyzers generally have a lower cost compared to those run on dry chemistry analyzers. 5 Currently, we are running both these system side by side in the Department of clinical biochemistry of Dhulikhel Hospital. The present study intends to compare the agreement of results between dry and wet chemistry systems for common clinical chemistry parameters i.e., Glucose, urea, creatinine, total bilirubin, total protein, albumin, total calcium, total cholesterol, triglyceride, HDL-Cholesterol, AST and ALT respectively.…”