Measuring the Cost of Inefficient Use of Laboratory Resources: Ecuador

The Quality Assurance Project (QAP) investigated strategies for increasing efficiency in hospital laboratory services, an area of hos­ pital operations that is frequently identified as high cost. The study developed measurement method­ ologies for seven separate sources of economic waste in hospital laboratories (unneeded tests, un­ claimed tests, resource use ineffi­ ciency, staffing inefficiency, expired reagents, poor quality control, and inefficient procurement) and tested them in three public hospitals in Ecuador. The methodologies were intended to provide rapid assess­ ments of the economic waste in each source and so relied on data from existing hospital records and relatively short turnaround surveys. Estimates of economic waste were made for each source by compar­ ing actual measured costs to what the costs would have been if stan­ dards were met. The application found that the mea­ surement methodologies were useable, in the sense that they could be applied and the requested data obtained. We found that eco­ nomic waste from unneeded tests and staffing inefficiency may be very large. Findings on a sample of unneeded tests in six disease categories (acute diarrhea in children and adults, pneumonia in children and adults, appendicitis, cholecistitis) indicated that roughly half were unneeded and may rep­ resent economic waste. This result Continued on page ii Measuring the Cost of Inefficient Use of Laboratory Resources: Ecuador