Biochemical and microscopic urinalysis: Time and cost in a nephrology laboratory

Giorgina Barbara Piccoli, Massimo Gai, Elisabetta Mezza, Fabrizio Fop, Vincenzo Cantaluppi, Marco Quaglia, Luigi Biancone, Alberto Jeantet, Giacomo Lanfranco, Giuseppe Paolo Segoloni

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Urinalysis is a fundamental test in internal medicine and nephrology. Figures for costs are available in the general laboratory, where biochemical and microscopic urinalysis are commonly performed as semi-automated screening tests. Information on costs is lacking in the nephrology laboratory, where a time-consuming morphological analysis is usually preferred. This study analyses the costs of urinalysis in a nephrology laboratory. Methods. In the nephrology laboratory at the University of Turin - Italy, biochemical urinalysis consists of multi-property strip and proteinuria/creatininuria, done by laboratory technicians. Phase-contrast microscopy is done by a nephrologist or biologist. Time dedicated to the tests was recorded by the same operator over 20 working days, during which 350 urine samples were processed (median 19/day, range 8-42). The production costs were calculated with the logic bottom-up technique. Results. Overall time needed was 11.9 minutes/sample. Biochemical urinalysis required 6.6 minutes/sample; time required and samples processed were inversely related (≤19 samples: 7.95 minutes/sample; >19 samples: 5.6 minutes/sample, p=0.01). Microscopic urinalysis took 5.3 minutes/slide; the best time-to-samples ratio was at 18-22 samples per day (with peak efficiency at 21 samples: 4.6 minutes). Cost of reagents and disposables was Euro (€) 1.06/sample. Time accounted for €5.32/sample (technicians, nephrologist-biologist), with total direct cost of €6.38/sample. Conclusion. In a nephrology laboratory, microscopic urinalysis is a time-consuming, expensive test. Analysis of cost and modalities may be useful, in a time of budget constrains, to maintain a role for this precious semeiotic art.

Original languageEnglish
Pages (from-to)575-579
Number of pages5
JournalJournal of Nephrology
Volume15
Issue number5
Publication statusPublished - Sept 2002
Externally publishedYes

Keywords

  • Costs
  • Nephrological laboratory
  • Urinalysis
  • Urinary sediment

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