The Reduction ways of Medicine Material Costs of Nuclear Medicine In Vitro

핵의학 체외검사의 진료재료비용 절감 방안

Purpose: In vitro uses dose response curve with 6 to 7 standard concentrations in every examination to analyze examination results and this use of dose response curve comprises a large portion of the consumption of medicine material. At this present, some ones of in-hospital examination items have shown mostly low result of distribution in the analyzed features and these examinations have been judged that it would be unnecessary to use the last standard concentration. Hence, this study selects those examination items showing low result of distribution and reviews the cases contributed to less consumption of medicine material and revenue growth of hospital by reduction of medicine material used in the place of the last standard concentration. Materials and Methods: The study was made targeting 11 examination items out of total 43 items of the in-hospital examination and since these examination items were mostly low in the features as the examination results of patients or the examination results were distributed to show lower concentration than the previous last standard concentration, it carried out the examination without using the last standard concentration, which could generate the effect to reduce medicine material (examination tube) used in the last standard concentration as many as the number of examination carried out. For this, it examined the number of medicine material reduction by month during the period from July, 2009 to February, 2011 and estimated the reduction amount of medicine material calculated the number of reduction by the unit cost of medicine material as well as the profit generated by the reduced medicine material to use for the medicine material of patient examination. Results: The total number of medicine material reduced during the period from July, 2009 to February, 2011 was 3,131 pieces, which had the effect to reduce the medicine material equivalent to about 31 kits of reagent. To calculate this by the unit cost of the medicine material, it analyzed to reduce about 6.4 million won of medicine material cost. Also the reduced medicine materials were used for medicine materials of patient examination and this was analyzed to generate about 13.75 million won of profit based on the ABC cost accounting. Conclusion: It showed no problem in the analysis of examination result even without using the last standard concentration regarding those examination items with low distribution of the patient examination result. For these examination items, it was able to reduce medicine material used for the last standard as many as the number of examination carried out. Also, the adjustment of concentration range was found to have no problem in the reliability of examination result. Therefore, this case will be applicable in those occasions of when the analysis of patient examination result is mostly distributed at the lower level or when an examination with the distribution of patient results in the range of lower concentration than the previous last standard concentration is carried out and this is considered to increase the efficiency in the use of medicine material in vitro as well as contribute to the profit of hospitals.

체외 검사는 각 검사 마다 6-7개의 standard 농도를 이용한 표준곡선(Dose response curve)을 사용하여 검사 결과를 분석하며, 표준곡선 사용은 진료재료 소모에 많은 부분을 차지하고 있다. 현재 원내에서 검사하는 검사항목 가운데 일부 검사 항목은, standard 농도를 이용한 환자의 검사 결과 분석수치가 대부분 낮은 결과의 분포를 보이고 있었으며, 이러한 검사 들은 마지막 standard 농도의 사용이 불필요하다고 판단하였다. 이에 낮은 검사 결과의 분포를 보이는 검사항목들을 선정하고, 마지막 standard 농도의 자리에 사용했던 진료 재료를 절감하여 진료재료의 소모비용을 줄였다. 원내 검사 항목 중 11개의 검사 항목을 진료재료 절감 대상항목으로 하였고, 검사가 진행한 횟수 만큼 마지막 standard농도에 사용되었던 진료재료(검사 Tube)를 절감할 수 있었다. 2009년 7월부터 2011년 2월까지 월별 진료재료 절감 개수, 절감 개수를 진료재료 단가로 계산하여 진료재료 절감액과, 절감된 진료재료를 환자 검사용 진료재료로 사용하여 발생한 수익을 ABC 원가계산을 근거로 산정하였다. 2009년 7월부터 2011년 2월까지 절감된 진료 재료는 3,131개였다. 이는 약 31kit의 검사 시약에 해당되는 진료재료를 절감하였다. 이것을 진료재료 단가로 계산하면 약 640만원의 진료재료비가 절감되었고, 이러한 진료 재료는 환자 검사 진료재료로 사용되어 약 1,370만원의 수익이 발생하였다. 환자의 검사 결과가 정상이거나, 낮게 분포하는 검사항목들은 마지막 standard 농도를 사용하지 않고 범위를 줄여서 검사를 진행하여도 검사 결과를 분석하는데는 영향이 없었고, standard 농도 범위 조정이 검사 결과의 신뢰성에는 영향이 없는 것으로 분석 되었다. 따라서 이 활동은 핵의학 체외검사의 진료재료 사용에 효율성을 높이고 진료재료 절감 및 병원 수익에 많은 효과가 있을 것으로 생각한다.