Cost of Quality-Applicability in Clinical Laboratories, Particularly in Resource-Limited Countries: A Survey of the Literature
Abstract:
Healthcare providers rely on laboratory results to make medical decisions daily. Laboratories must adhere to specified requirements to ensure that the service provided is reliable and safe. The service provided to patients and clinicians should therefore be customer-focused. Discussions on expenditure on continuous quality improvement activities have grown as more laboratories develop quality management systems. This discussion is even more relevant as laboratory managers try to balance their organization’s productivity by reducing waste and unnecessary expenditure. Quality cost is the total cost of activities that prevent or mitigate errors in laboratory processes (cost of good quality), and failure cost is the cost resulting from flawed laboratory processes (cost of poor quality). There is extensive evidence on the application of CoQ in manufacturing and other non-health service industries, however there is limited information about its applicability in clinical laboratories. Furthermore, laboratories located in countries with scarce resources may face unique challenges in assessing quality costs, including the ease of data collection for cost inputs. This article examines the information presented in the literature on quality-related costs in clinical laboratories. Secondly, it provides a summary of various cost models. Finally, it explores the application of quality cost in clinical laboratories, particularly in resource-limited countries, and outlines the benefits and challenges.References:
[1]. Oliver J, Qu W. Cost of
quality reporting: some Australian evidence. Int J Appl Qual Manag.
1999;2:233-50.
[2]. Sower VE, Quarles R, Broussard
E. Cost of quality usage and its relationship to quality system maturity. Int J
Qual Reliab Manag. 2007;24(2):121-40.
[3]. Schiffauerova A, Thomson V.
Managing cost of quality: insight into industry practice. TQM Mag. 2006.
[4]. Schiffauerova A, Thomson V. A
review of research on cost of quality models and best practices. Int J Qual
Reliab Manag. 2006;23(4).
[5]. Glogovac M, Filipovic J.
Quality costs in practice and an analysis of the factors affecting quality cost
management. Total Qual Manag Bus Excell. 2018;29(13-14):1521-44.
[6]. Quintenz A, Williams P.
Exploring cost of quality in the lab. Med Lab Obs. 2019;51(1):24-5.
[7]. Elbireer A, Gable AR, Brooks
Jackson J. Cost of quality at a clinical laboratory in a resource-limited
country. LabMedicine. 2010;41(7):429-33.
[8]. Crosby PB. Quality is free:
the art of making quality certain. New York: New American Library; 1979.
Reprint. Accessed 2026 Apr 22. Available from: https://archive.org/details/qualityisfreeart00cros/mode/2up
[9]. Foulad R, Amellah SJ,
Jebli S, et al. Cost
of quality: literature review, correspondence between models, and a call for a
paradigm shift. Int J Adv Appl Sci. 2023;10(2):39-49.
[10]. Campanella J. Principles of
quality costs: principles, implementation, and use. Milwaukee (WI): American
Society for Quality Control Quality Press; 1990. Accessed 2026 Apr 25.
Available from: https://archive.org/details/principlesofqual0000camp/mode/2up
[11]. Zahar M, Barkany EA,
Biyaali EA. Cost
of quality health care: a case study in clinical laboratory. Ann Fac Eng
Hunedoara Int J Eng. 2015;13(1):121-5.
[12]. Rattan A. Understanding cost
of quality in the laboratory. Acta Sci Microbiol. 2021;4(11):16-20.
[13]. Vaxevanidis NM, Petropoulos G.
A literature survey of cost of quality models. Ann Fac Eng Hunedoara J Eng.
2008;6(3):274-83.
[14]. Murumkar A, Teli SN,
Bhushi UM, et al. Hidden
cost of quality: a review. In: Proceedings of the 11th ISDSI International
Conference; 2017; IIM Trichy, India.
[15]. Feigenbaum AV. Total quality
control. New York: McGraw-Hill; 1991. Accessed 2026 Apr 24. Available from: https://archive.org/details/totalqualitycont0000feig/mode/2up
[16]. Juran JM. Quality-control
handbook. New York: McGraw-Hill; 1951. Accessed 2026 Apr 24. Available from: https://archive.org/details/qualitycontrolha0000jmju/mode/2up
[17]. Juran JM, Gryna FM,
Bingham RS. Quality-control
handbook. 3rd ed. 1974. Accessed 2026 Apr 24. Available from: https://archive.org/details/qualitycontrolha0000unse/mode/2up
[18]. Sandoval-Chávez DA,
Beruvides MG. Using
opportunity costs to determine the cost of quality: a case study in a
continuous-process industry. Eng Econ. 1998;43(2):107-24.
[19]. Menichino T. A cost-of-quality
model for a hospital laboratory. Free Library. 1992. Accessed 2026 Apr 21.
Available from: https://www.thefreelibrary.com/A+cost-of-quality+model+for+a+hospital+laboratory.-a011815914
[20]. Carlson OR, Amirahmadi F,
James SH, et al. A primer on the cost of quality for improvement of laboratory
and pathology specimen processes. Am J Clin Pathol. 2012;138:347-54.
[21]. Plunckett JJ, Dale BG. Some practicalities and pitfalls of quality-related cost collection. Proc Inst Mech Eng B. 1985;199(B1).
