Utilization Management to Reduce Use of Laboratory Investigations in Warinchamrap Hospital, Ubonratchathani - การบริหารทรัพยากรสุขภาพเพื่อลดการส่งตรวจ ทางห้องปฏิบัติการ ในโรงพยาบาลวารินชำราบ จังหวัดอุบลราชธานี

Abstract

             Healthcare reform has increased accessibility to medical care. Active management and comprehensive utilization management are necessary to response to demand and satisfaction of patients in situation that increases medical service costs, including laboratory material costs. The objective of this study was to develop utilization management system using evidence-based medicine to make clinical policy to reduce unnecessary laboratory investigations in a hospital setting. This study was an action research conducted between October 2013 to September 2014 in Warinchamrap Hospital, Ubonratchathani province. The number and proportion of laboratory investigations as well as the overall cost of laboratory reagents were compared before and after the intervention using descriptive statistics - number and percentage. The process had 4 steps: planning, doing, checking and acting for results to bring policy into practice. It was found that there was reduction in the requests for laboratory investigations of electrolyte, BUN/creatinine, thyroid function test, HbA1C and investigation panel for diagnosis of acute febrile illness. Overall, the intervention had reduced the costs for laboratory investigation up to 3.4 million baht or 21.6% from the baseline cost of 15.9 million baht while productivity (amount of in-patient and case-mix index) were not reduced. The authors recommended that the approach should be applied in all hospitals in order to improve efficiency of health resource management.

Key words: utilization management, laboratory investigation, evidence-based medicine