The operation, quality and costs of a district hospital laboratory service in Malawi
The operation, quality and costs of a district hospital laboratory service in Malawi
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DOI：
10.1016/s0035-9203(03)90070-8
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发表时间：
2003-07-01
影响因子：
2.2
通讯作者：
Gilks, CF
中科院分区：
文献类型：
--
作者：
Mundy, CJF;Bates, I;Gilks, CF
许多低收入国家的实验室服务水平下降，严重限制了它们对患者护理和疾病监测的投入。关于较贫穷国家实验室服务各个组成部分的质量和成本的数据很少，但如果要充分利用稀缺资源，这些信息至关重要。在马拉维一个典型的地区医院实验室中，对工作人员的时间、测试范围、工作量和安全程序进行了 12 个月（1997-98 年）的监测。收集数据是为了计算这些服务的总经济成本。在进行的 31203 项检测中，84% 用于支持输血以及疟疾和结核病 (TB) 的诊断。疟疾和结核病显微镜检查以及输血的测试质量合理，但血红蛋白估计的测试质量较差。每次检测的费用从血红蛋白 0.35 美元到每单位血液 11.7 美元不等，实验室服务的年度总费用为 32 618 美元。输血和疟疾和结核病显微镜检查构成了大部分检测。因此，确保这些测试具有最高质量将对减少实验室资源的浪费产生最大的影响。血红蛋白估计质量不足是一个特殊问题。这项研究的结果可能与其他具有类似疾病负担的低收入国家相关。
Laboratory services are run down in many low-income countries, severely constraining their input to patient care and disease surveillance. There are few data about the quality and cost of individual components of the laboratory service in poorer countries, yet this information is essential if optimal use is to be made of scarce resources. Staff time, range of tests, workload, and safety procedures were monitored over 12 months (1997-98) in a typical district hospital laboratory in Malawi. Data were collected to calculate the total economic cost of these services. Of the 31203 tests performed, 84% were to support blood transfusion and diagnosis of malaria and tuberculosis (TB). Test quality was reasonable for malaria and TB microscopy and blood transfusion, but poor for haemoglobin estimation. The cost per test ranged from US$0.35 for haemoglobin to US$11.7 per unit of blood issued and the total annual cost of the laboratory service was US$32 618. Blood transfusion and microscopy for malaria and TB comprised the majority of tests. Ensuring that these tests are of the highest quality will therefore have the most impact in reducing wastage of laboratory resources. Inadequate quality of haemoglobin estimations is a particular problem. The findings of this study are likely to be relevant to other low-income countries with similar disease burdens.