Original Research

Cost of running a full-service receiving office at a centralised testing laboratory in South Africa

Naseem Cassim, Neeshan Ramdin, Sadhaseevan Moodly, Deborah K. Glencross
African Journal of Laboratory Medicine | Vol 11, No 1 | a1504 | DOI: https://doi.org/10.4102/ajlm.v11i1.1504 | © 2022 Naseem Cassim, Neeshan Ramdin, Sadhaseevan Moodly, Deborah K. Glencross | This work is licensed under CC Attribution 4.0
Submitted: 29 December 2020 | Published: 13 July 2022

About the author(s)

Naseem Cassim, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, National Health Laboratory Service, Johannesburg, South Africa
Neeshan Ramdin, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Sadhaseevan Moodly, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, National Health Laboratory Service, Johannesburg, South Africa
Deborah K. Glencross, Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, National Health Laboratory Service, Johannesburg, South Africa


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Abstract

Background: The National Health Laboratory Service operates a platform of 226 laboratories across South Africa, ranging from highly sophisticated central academic hospitals to distant rural hospitals. The core function of the National Health Laboratory Service is to provide cost-effective and efficient health laboratory services in the public healthcare sector.

Objective: This study aimed to assess the comprehensive cost of running a full-service receiving office (RO) at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) laboratory.

Methods: Top-down costing was conducted, with the cost per registration as the main outcome of interest. The annual equivalent costs (AEC) for the following categories were determined: registration materials, collection materials, staffing, laboratory equipment, building and electricity, and other operating costs. Data for the period from 01 April 2019 to 31 March 2020 were included in the analyses.

Results: The AEC was $1 657 483.00 United States dollars (USD) and the cost per registration was $0.766 USD. Staff contributed 59.9% of the total cost per registration, while collection materials contributed 21.4%. The RO core staff (data clerks) contributed 50.8% of the total staffing costs, while messengers and drivers contributed 31.2%. The introduction of order entry at the CMJAH and other primary healthcare facilities reduced the total AEC by 20%. A single order entry application would serve both the CMJAH and primary healthcare facilities - hence we would prefer to not refer to order entries.

Conclusion: Providing a comprehensive RO service costs approximately $1.00 USD per registration. The implementation of order entry at the CMJAH would reduce AECs substantially and improve efficiency.


Keywords

receiving office; cost per registration; order entry; costing; pre-analytical

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