Cost-effective study of determination methods for low-density lipoprotein by new direct assay compared to Friedewald's formula calculation in hypercholesterolemic subjects.

OBJECTIVE: To study the cost effectiveness of determination methods for low-density lipoprotein by new direct assay compared to Friedewald's formula calculation. DESIGN: descriptive study. MATERIAL: Fasting serum from 100 subjects with a history of hypercholesterolemia. METHOD: Specimens were determined for total cholesterol, high-density lipoprotein (HDL) and triglyceride using automated clinical chemistry, as the basic information in calculation of LDL level. Each specimen was also processed by direct LDL assay by the same automation. Correlation of the results from both methods was analyzed. Cost effectiveness analysis was then performed. RESULTS: The least-squares equation from comparing direct LDL assay to calculation method gave Y = 0.897X + 20.42 (r = 0.996, p < 0.05). According to the present study, the cost per utility of the direct assay method (47.54 baht) was more expensive than the calculation method (29.59 baht). CONCLUSION: The results from both methods were well related. However, the cost per utility of the calculation method is cheaper, therefore, the authors recommend the use of the calculation method rather than the direct assay for follow-up of LDL level in hypercholesterolemic patients.

A study of unit cost of routine investigations in Srinagarind Hospital.

We have used the step up allocation accounting method to determine the actual costs of complete blood count, urinalysis, chest radiograph and electrocardiogram. We found that the actual costs were quite different from the price set up by the hospital. The actual cost were much higher than the price for the complete blood count and urinalysis and much lower for the chest radiographs and especially for electrocardiogram. We propose that in performing economic analysis involving all these investigations, the actual cost should be used instead of the price.