Effect on hospital operation costs of rational laboratory usage method with evidence based medicine: A university hospital application example

Purpose: To reduce the laboratory operation costs by preventing unnecessary examination requests and to contribute to the more effective and efficient use of hospital resources by integrating the rational laboratory system with evidence-based medicine applications into the hospital processes by protecting patient safety. Method: The primary data collection technique was used as data collection method in the study. Based on this technique, document review and focus group interviews (physician interviews) were conducted using qualitative research technique. The universe of the study consists of all the data in the laboratory of Düzce University Education Application and Research Center (Hospital), while the data evaluated for rational laboratory application within this universe constitute the sample of the research. In accordance with the purpose of the study, the data in question were given comparatively before the Rational Laboratory Application ALU (between 01.06.2018-31.12.2018) and after ALU (between 01.06.2019 and 31.12.2019). Findings: During the 7-month period before ALU, a total of 446,300 examination requests were made and the cost of these examinations was found to be 1,591,063 TL. A total of 475,585 examination requests were made for 7 days after ALU and the cost of these examinations was found to be 1,537,903 TL. When the number of examination requests before and after ALU is taken, it was determined that there was an increase of 6.56%, but when compared to the amount, the costs decreased by 3.34%. Although the number of inspection requests increased, it was found that the inspection amounts decreased. It has been observed that the prices of the examinations with increasing number of requests are low, and the prices of the examinations with decreasing number of requests are high. When the units are examined in terms of the number of inspection requests, it is seen that 13 (43.3%) out of 30 units succeed by decreasing the number of requests. The number of inspection requests increased contrary to expectations and the number of unsuccessful units is 17 (56.67%). When the units are analyzed in terms of inspection costs, it is seen that 18 (60%) out of 30 units are successful by decreasing costs. The number of units that fail by increasing their costs contrary to expectations is 12 (40%). It has been observed that the successful units are predominantly Surgical units, while the unsuccessful units are internal units that require more analysis. Results: It has been concluded that the rational laboratory system applied in the axis of evidence-based medicine reduces hospital operation costs on the condition of protecting patient safety, therefore this method can be a tool for more effective and efficient use of hospital resources. Key words: Rational Laboratory, Evidence-Based Medicine, Hospital Costs, Cost Accounting.