RESUMO
BACKGROUND: Preanalytical errors account for most laboratory errors. Although the frequencies of preanalytical errors are well characterized in the literature, little is known regarding the costs of these errors to the laboratory. OBJECTIVE: To analyze costs associated with preanalytical errors associated with the international normalized ratio (INR) test. METHODS: We performed a retrospective analysis of INR requests associated with preanalytical error codes from January 2009 through September 2013. Preanalytical error types were those related to order entry (no specimen collected) and those unrelated to order entry (insufficient specimen quantity or specimen-integrity concerns). We calculated the cost of analysis of a specimen and the cost of investigating errors. RESULTS: During the study period, there were 557,411 INR requests, 13.1% of which were associated with a preanalytical error code. The total annual cost of INR testing was USD $379,222.50. Investigation and reporting of preanalytical errors not related to order entry represented 10.5% of our annual INR testing budget (USD $39,939.00). CONCLUSIONS: Minimizing preanalytical errors has the potential to result in significant cost savings.
Assuntos
Redução de Custos/estatística & dados numéricos , Erros de Diagnóstico/estatística & dados numéricos , Coeficiente Internacional Normatizado/economia , Orçamentos , Canadá/epidemiologia , Técnicas de Laboratório Clínico , Humanos , Coeficiente Internacional Normatizado/normas , Fase Pré-Analítica , Manejo de Espécimes , Centros de Atenção TerciáriaRESUMO
BACKGROUND: To compare the rate of postoperative complications of patients with advanced head and neck cancer treated with the chemoradiation protocol "RADPLAT" with that of a similar cohort of patients treated with primary surgery. METHODS: We retrospectively analyzed 50 patients treated with RADPLAT and 50 patients treated with primary surgery. RESULTS: The rates of complications for local wound problems were 54% and 42%, respectively, for the RADPLAT cohort and the primary surgery cohort. However, the rate of local complications for the subset of RADPLAT patients undergoing clean-contaminated surgery was 69% (p =.305). The rates of complications for medical (systemic) problems were 10% and 12%, respectively, for RADPLAT versus primary surgery patients. There was no significant difference in hospitalization time between the groups. CONCLUSIONS: Among patients with advanced head and neck cancer, surgical complications are high but not significantly different between patients undergoing the chemoradiation protocol "RADPLAT" and those undergoing primary surgery.
