Racionalización de la utilización y costes del laboratorio en atención primaria: protocolización de solicitudes analíticas

OBJECTIVE: To present a multiple interventionist strategy, with a combined genesis, that may help improve the effectiveness and efficiency of Primary Care laboratory use. DESIGN: Retrospective observation study. SETTING: Three Health Districts in Barcelona province: Manlleu, Santa Eugenia de Berga and Sant Hipolit de Voltrega. PATIENTS AND OTHER PARTICIPANTS: The study looked at 2,960 lab analysis requests in two months from professionals in three Health Districts. The requests were classified and codified in line with the most prevalent Primary Care health problems and conditions for which lab tests are necessary. An analytic protocol agreed by Primary Care and Laboratory professionals was worked out for each of these situations. The costs of analytic requests before (free request) and after (application of protocols) were compared. MEASUREMENTS AND MAIN RESULTS: The pathologies for which the greatest savings were achieved were: General Health Review, Hypertension and Lipaemia. Total saving was 1,862,226 pesetas in two months, equivalent to 11,173,356 pesetas per year. CONCLUSIONS: The strategy of protocolising lab requests involves savings which permit setting up an incentive system, based on compliance with the strategy, for the professionals involved.