Development of Rational Laboratory Use System According to Lamphun Hospital RLU Policies

Development of Rational Laboratory Use System

Abstract

         This research was conducted at Lamphun Hospital to monitor the progress of the Rational Laboratory Use (RLU) policy, which consisted of 5 steps: beginning, analysis, practice, resolution, and re-analysis and summary. A comparison of laboratory investigation data from outpatient department (OPD) cases was studied between the year 2022 (before RLU implementation) and 2023 (after RLU implementation). The results demonstrated that the utilization of the RLU policy at Lamphun Hospital potentially reduced the total cost of laboratory investigation by approximately 1.1 million THB within the 7-month study period. The number of tests used for Dengue diagnosis showed the greatest reduction, decreasing from 44.3% in 2022 to 10.5% in 2023 (p-value = 0.01). Furthermore, the RLU policy helped address under-investigation issue, particularly in HbA1c testing. In 2022, HbA1c was examined only 19% of diabetic patients, while this increased to 23% in 2023 (p-value = 0.05). However, no significant difference was observed in the number of Liver Function Test and Lipid profile. Since these tests were classified as clinical basic clinical investigation, and their results were crucial for doctor to make informed decision regarding to drug management during each hospital visit. This first study confirmed the importance of the RLU policy. It is encouraging that the RLU policy can be adapted to various situations in other hospitals to achieve cost-effective system management and cost reduction in the future.