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Pre-Analytical Error Cost Analysis of 10,732 Contaminated Urine Culture Samples by Pinar Eker

Background: Unlike other pre-analytical (PA) phase errors, in our country Social Security Institution (SSI) reimburses urine samples rejected due to contamination in the form of a finalized test. The primary purpose was to estimate the direct financial loss created by contaminated urine sampling. We want to encourage its prioritization among corrective and preventive actions of laboratory PA management.
Methods: We examined the urine samples which were sent to Istanbul Anatolian North Central Laboratory retrospectively. The central laboratory serves the community of 6,400-bed hospitals. We made direct financial loss calculations with material-, labor-, and waste-related financial elements.
Results: We rejected 10,732 of 138,834 samples due to contamination. With the 2019 Euro Index, the cost for each urine sample rejected due to contamination was calculated as € 2.98.
Conclusions: It is the first cost study where the prices are in human resources, material, waste cost, and the amount reimbursed by SSI as direct cost elements per rejection sample. Highlighting the cost elements in establishing health policies predicted due to their striking feature may contribute to their prioritization in corrective and preventive actions. The urine culture test is the most commonly performed bacterial culture test. The determination of financial loss predicted that it would also reduce antibiotic resistance in healthcare by providing financial resource threshold information to develop improved methods. In addition, it will inspire new additions to the existing few detailed pre-analytical error cost studies.

DOI: 10.7754/Clin.Lab.2021.210828