Utjecaj uvođenja deriviranog fibrinogena na financijsko poslovanje laboratorija

master's thesis

• Title (english): How Using Derived Fibrinogen Method Affects Financial Performance of a Laboratory
• Author: Martina Prkić
• Mentor: Dunja Rogić (mentor)
• Committee member: Dunja Rogić (predsjednik povjerenstva)
• Committee member: Nada Vrkić (član povjerenstva)
• Committee member: Desiree Coen Herak (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2018-12-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

Izračunavanje koncentracije fibrinogena iz krivulje kojom je analizirano protrombinsko vrijeme kod hospitaliziranih
pacijenata jedna je od mjera uštede koju koriste brojni laboratoriji. U ovom diplomskom radu obrađeni su podatci
izdanih pretraga fibrinogena i deriviranog fibrinogena u redovnom i hitnom laboratoriju Kliničkog zavoda za
laboratorijsku dijagnostiku KBC Zagreb unutar prvih devet mjeseci 2018. godine. Ukupna ušteda laboratorija
zamjenom eksperimentalne metode deriviranim fibrinogenom u tom razdoblju iznosi 107.897,36 kn. Budući da je
pretraga deriviranog fibrinogena uvedena kao mjera štednje 2014. godine, tijekom te četiri godine ušteđeno je oko
575.000,00 kn.
Ako se ispravno postave kriteriji, dolazi do velike uštede financijskih sredstava, ali isto tako i uštede vremena koje je
potrebno za izdavanje koagulacijskog nalaza što moţe biti od osobite važnosti u hitnim stanjima. Međutim, potrebno
je imati na umu kako ova metoda nije međulaboratorijski usporediva te se ne bi smjela koristiti kod vanjskih
pacijenata. Također, zbog velikog broja nedostataka koji se pojavljuju uglavnom u patološkim stanjima, koja su i
češća kod hospitaliziranih bolesnika, bilo je potrebno jako pažljivo odrediti kriterije korištenja ove metode kako bi
razina kvalitete rezultata koagulacijskih pretraga ostala očuvana unatoč značajnom smanjenju financijskog opterećenja
laboratorija. Ipak, u određenim stanjima, kao što je diseminirana intravaskularna koagulacija, dobiveni rezultati mogu
biti čak i točniji od rezultata izmjerenih modificiranom Claussovom tehnikom. Isto tako, treba uzeti u obzir i plato
područja sigmoidne krivulje koja se primjećuju kod pretjerano niskih i visokih vrijednosti u plazmi. Ipak, uzevši u
obzir sva ograničenja koja ova metoda donosi, moguće je i uz stroge uvjete postići značajnu uštedu od oko tri četvrtine
resursa u odnosu na izvođenje ove pretrage modificiranom Claussovom metodom što postaje vrlo relevantno u
smanjenju troškova laboratorija i moţe činiti integralni dio uštede većih bolničkih centara.

Abstract (english)

Calculating fibrinogen concentration from data availalble in prothrombine time curve in samples from hospitalized
patients is one of the measures of savings that a lot of laboratories use. This paper covers the data of released results of
fibrinogen and derived fibrinogen in routine and emergency laboratories at Clinical Hospital Centre Zagreb in the first
nine months of 2018. The total savings obtained by switching from experimental Clauss essay method to prothrombin
time derived fibrinogen are 107, 897.36 kn. Because this method of measurment started in 2014, during this four years
the savings are around 575,000.00 kn.
If the criteria are set up correctly, a large amount of money can be saved, and also a lot of time for issuing the
coagulation report which is particularly important in emergency situations. But this method isn't comparable between
laboratories and it shouldn't be used with external patients. Also, because of a great deal of defects that appear mostly
in phatological state that are also more common among hospitalized patients, the criteria for using this method had to
be chosen very carefully, so that the quality level of coagulation reports stays maintained, inspite of a significant
reduction in the finantial burden of the laboratory. What's more, in certain phatological states, such as disseminated
intravascular coagulation, the results may be even more correct than the results given by the modified Clauus
technique. Of course, the plateau areas at the beginning and the end of the sigmoid curve in plasma measurments need
to be taken into account. After taking in consideration all of the restrictions this method carries and providing it's being
carried out under strict conditions, it's possible to achieve significant savings of about three quarters of resources. That
fact becomes very relevant in reducing the laboratory expenses and it can become an integral part of savings for bigger
hospital centers.

• Keywords: fibrinogen; derivirani fibrinogen
• Keywords (english): fibrinogen; derived fibrinogen
• Language: croatian
• URN:NBN: urn:nbn:hr:163:419109
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-02-14 08:31:59