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- Ekblom, Kim, 1970-, et al.
(författare)
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Introduction of Cost Display Reduces Laboratory Test Utilization
- 2018
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Ingår i: American Journal of Managed Care. - : Managed Care & Healthcare Communications LLC.. - 1088-0224 .- 1936-2692. ; 24:5, s. E164-E169
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the effects on the number of laboratory tests ordered after introduction of cost display (showing the cost in the computerized test ordering system at test ordering and test result delivery) and cost charge (requiring all primary healthcare centers to pay full laboratory costs of the ordered tests).Study design: The study included cost display for secondary healthcare centers (inpatient hospitals, emergency departments, and outpatient specialist providers) as well as publicly and privately operated primary healthcare centers (sites of nonemergency, nonspecialist healthcare). After 3 months cost charge was introduced by management for all primary healthcare centers.Methods: Information on laboratory test name in the test ordering system, resulting in cost display both at the moment of test ordering and at the presentation of the test result. Numbers of laboratory tests were obtained from the laboratory information system and calculated as tests per physician visit. Cost charge was managed through the established laboratory invoicing system.Results: In the publicly operated primary healthcare centers, neither if the interventions had any effect on laboratory test volume, nor did cost display have an effect in the privately operated primary healthcare centers. However, introduction of cost charge significantly decreased laboratory test ordering in the privately operated primary healthcare centers.In contrast, secondary healthcare centers lowered test volumes when cost display was introduced.Conclusions: The results support cost awareness and cost charge as means of reducing laboratory utilization. However, the outcome varies with the setting.
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- Petersson, Annika, et al.
(författare)
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Evaluation of a routine hematology analyzer for quality control of leukoreduced plasma
- 2019
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Ingår i: Transfusion. - : Wiley. - 0041-1132 .- 1537-2995. ; 9:10, s. 3214-3218
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Quality control of residual white blood cells (WBCs) and red blood cells (RBCs) in leukoreduced plasma is mandatory. Although technological advances have been made, analysis of quality controls using routine hematology analyzers has not generally been introduced. The aim of this study was to evaluate if the routine hematology analyzer Sysmex XN‐10, (Sysmex Nordic ApS) could be used for quality control of residual WBCs and RBCs in leukoreduced plasma.STUDY DESIGN AND METHODS: Linearity, accuracy, and precision were established for two Sysmex XN‐10 analyzers using spiked donor plasma. ADAM rWBC (NanoEnTek) and manual counting in the Bürker chamber (NanoEnTek) were reference methods for WBCs and RBCs, respectively. Twenty‐five consecutive leukoreduced donor plasma samples were also tested.RESULTS: For WBCs, the linearity criteria were met for the ADAM rWBC, but not for the Sysmex XN‐10 instruments. Precision on both Sysmex XN‐10 instruments was accurate only at 6 cells/μL, and accuracy was consistently acceptable only at 5 to 6 cells/μL. The precision and accuracy of the ADAM rWBC were acceptable at 2 to 6 cells/μL.For RBCs, both Sysmex XN‐10 instruments and manual counting in the Bürker chamber were linear and fulfilled the precision criteria. Accuracy was acceptable for both Sysmex instruments at 6 to 12 × 109 WBCs/L but fluctuated within the study's measuring range for the Bürker chamber.No false‐positive results were seen in the 25 consecutive donor plasma samples tested.CONCLUSION: For quality control purposes of leukoreduced plasma, the Sysmex XN‐10 analyzer is suitable for the enumeration of residual RBCs but not of residual WBCs.
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