A One-year Cross-sectional Study on Analysis of Financial Losses in Serology Section of Microbiology Laboratory: A Quality Improvement Project

Introduction: Clinical diagnostic laboratories hold a significant place in healthcare as they play an important role in diagnosis, treatment and prevention of disease and draw a substantial hospital budget as well as generate considerable revenue. Profit earned by a diagnostic laboratory is the difference between the income generated from and expenditure incurred by the laboratory in performing laboratory tests. These expenses can be further divided into: i) direct cost-amount related directly to test performance, supplies and labour; and ii) indirect costs apply to items necessary to run laboratory, are not test specific. It has been observed that apart from expenditures mentioned above, there are several financial losses that are not evident in terms of their presence and magnitude are not taken into account by the cost-accounting system. Aim: To identify hidden losses, analyse its magnitude in terms of financial loss and identify the reasons for the same in serology section of Microbiology laboratory. Materials and Methods: This quality improvement, crosssectional study was conducted at serology section of Microbiology laboratory, Shree Krishna Hospital, Karamsad, Gujarat, India from 1st April 2021 to 31st March 2022 which included all tests/control repeated, tests which are outsourced due to unavailability of test kits or consumables required to run the test, test kits/devices that crosses the expiry date and are discarded unused were included in the study. All calculations were done in Indian National Rupees (INR) with predefined formulas in Microsoft excel sheet involving simple summation and deduction to find out financial loss in particular category. As it was time bound study all the tests fulfilling inclusion criteria were included. Result: Maximum loss was observed in serology section was due to: (i) repeat testing, 55508.9 INR; and (ii) outsourcing of tests due to unavailability of test kits or consumables, 10485 INR. No loss observed due to kit/test device crossed expiry date and are discarded unused. Conclusion: This study will enable the laboratory to plan and implement corrective and preventive actions that are targeted towards reduction of such financial losses and generate more profit at laboratory level.