Cost analysis as the basis for management decisions in automation of enzyme immunoassays for HIV infection

Every year, about a fifth of the Russian population undergoes laboratory testing for HIV infection, which creates a significant burden on the healthcare system. A significant part of the research on markers of HIV infection is performed using ELISA test systems, usually using manual labor of personnel. The decision to automate this process should be based on the results of a comparative analysis of the direct costs of manual and automated methods.

The purpose statement is to evaluate the impact of automation on the labor intensity and cost of ELISA tests for antibodies to HIV1.2 / p24 antigen, depending on changes in the number of laboratory tests and the mode of operation of automatic equipment.

Materials and methods. The study of costs was carried out for the manual ELISA method and for automated execution using the ELISA analyzer «Lazurit». To analyze the labor costs of the personnel, the timing of the workplaces of the medical laboratory was performed. When modeling various flows of biomaterial samples, the number of laboratory tests was used, which is a multiple of the 1st plate of the ELISA test system. The assessment of the influence of the operating modes of the automatic analyzer was carried out with a working shift of 7.2 hours and 12 hours.

Results. Automation of ELISA in conditions of medium and large volumes of testing saves labor by more than 1.6 times with a work schedule of 7.2 hours, and more than 1.9 times with a schedule of 12 hours. At the same time, automation increases the technological cost at low flows by more than 2 times, and at high flows — by 1.2 times. Conclusion. Automation of HIV testing using an ELISA analyzer leads, in general, to a negative economic effect due to a significant excess of the cost of additional consumables and depreciation of equipment over the possible savings in the wage fund. However, with a load exceeding 3–4 ELISA plates per day per 1 medical laboratory technician, automation can be an effective alternative to increasing the laboratory staff. Optimal for automated ELISA at medium and high flows is a 12-hour work schedule. 

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