Analysis of Determinants of Laboratory Equipment Operational Cooperation System Based on Cost Benefit Analysis in Hospital Management Perspective in X

  • Nursep Kemalayanti Master of Public Health Study Program, Faculty of Medicine, Andalas University, Indonesia
  • Firdawati Master of Public Health Study Program, Faculty of Medicine, Andalas University, Indonesia
  • Rima Semiarty Master of Public Health Study Program, Faculty of Medicine, Andalas University, Indonesia
Keywords: Operational Cooperation, Laboratory Equipment, KSO Success

Abstract

Procurement of laboratory equipment through operational cooperation is increasingly adopted by hospitals as a cost-effective and efficient strategy to support health services. This study examines the success of operational cooperation in procuring hematology analyzer equipment to replace damaged units, using a cost-benefit analysis (CBA) from the perspective of hospital management. Employing a sequential explanatory mixed-method approach, the study combined qualitative data from in-depth interviews with 12 purposively selected informants and observations, with quantitative analysis of secondary data using the CBA method. The analysis revealed a positive Net Present Value (NPV) of IDR 99,422,367.47 and a Benefit-Cost (B/C) ratio of 1.59, both exceeding the benchmarks of independent procurement. This indicates that operational cooperation is financially feasible and preferable. Non-financial benefits also strengthen this conclusion, including vendor-provided maintenance technicians, guaranteed supply of reagents and spare parts, and ongoing equipment upgrades aligned with technological advancements. These advantages minimize hospital disruptions and ensure service continuity. The study identifies key success determinants in the operational cooperation system: cost efficiency, human resources, regulatory compliance, vendor partnerships, equipment quality, historical laboratory data, and alignment with technological developments. In conclusion, operational cooperation for hematology analyzers is successful, sustainable, and offers significant benefits, both financial and operational, for hospitals.

References

Bernal-Delgado, E., & Angulo-Pueyo, E. (2023). Purchasing arrangements to strengthen the quality of chronic care in three Spanish autonomous communities: case study. World Health Organization.

Brown, M., Snelling, E., De Alba, M., Ebrahimi, G., & Forster, B. B. (2023). Quantitative assessment of computed tomography energy use and cost savings through overnight and weekend power down in a radiology department. Canadian Association of Radiologists Journal, 74(2), 298-304. https://doi.org/10.1177/08465371221133074

Emami, A., Welsh, D. H., Davari, A., & Rezazadeh, A. (2022). Examining the relationship between strategic alliances and the performance of small entrepreneurial firms in telecommunications. International Entrepreneurship and Management Journal, 1-26. https://link.springer.com/article/10.1007%2Fs11365-021-00781-3

Espín, J., Rovira, J., Calleja, A., Azzopardi-Muscat, N., Richardson, E., Palm, W., & Panteli, D. (2016). How can voluntary cross-border collaboration in public procurement improve access to health technologies in Europe. Health systems and policy analysis, policy brief, 21.

Etukudoh, N. S., & Obeta, U. M. (2021). Patients’(clients) satisfaction with medical laboratory services contributes to health and quality improvement. In Healthcare Access. IntechOpen. http://dx.doi.org/10.5772/intechopen.99290

Feinberg, B., & Zanardi, M. (2022). Analysis of the Influence of Operational Costs on Increasing the Financial Performance of American Public Helath Corporation. MEDALION JOURNAL: Medical Research, Nursing, Health and Midwife Participation, 3(2), 44-57. http://dx.doi.org/10.59733/medalion.v3i2.18

Garg, A. (2023). Department Wise Equipment Detailing. In Monitoring Tools for Setting up the Hospital Project: Initial Planning, Building and Equipment (pp. 357-468). Singapore: Springer Nature Singapore.

Hapsari, E. S., Suprihanto, J., & Sulastiningsih. (2019). Evaluasi pelaksanaan kerjasama operasional alat radiodiagnostik di RSUP DR. Sardjito tahun 2014–2016 [Tesis, STIE Widya Wiwaha].

Hartanto. (2015). Inovasi pelayanan laboratorium patologi klinik rumah sakit era BPJS. STIE IPWIJA.

Havighurst, C. C. (1995). Health care choices: private contracts as instruments of health reform. American Enterprise Institute.

Hawkins, R. (2012). Managing the pre-and post-analytical phases of the total testing process. Annals of laboratory medicine, 32(1), 5-16. https://doi.org/10.3343/alm.2012.32.1.5

Hinrichs-Krapels, S., Ditewig, B., Boulding, H., Chalkidou, A., Erskine, J., & Shokraneh, F. (2022). Purchasing high-cost medical devices and equipment in hospitals: a systematic review. BMJ open, 12(9), e057516. https://doi.org/10.1136/bmjopen-2021-057516

Holtbrügge, D. (2004). Management of international strategic business cooperation: Situational conditions, performance criteria, and success factors. Thunderbird International Business Review, 46(3), 255-274. http://dx.doi.org/10.1002/tie.20008

Indarto, T., Suhadi, & Poernomo, I. (2021). Evaluasi faktor-faktor yang mempengaruhi kinerja proyek KSO (Kerjasama Operasional) di Indonesia menggunakan analisis structural equation modelling (SEM). Rancang Bangun Teknik Sipil, 7(1), 36–46.

Joseph, T. M., Unni, A. B., Joshy, K. S., Kar Mahapatra, D., Haponiuk, J., & Thomas, S. (2023). Emerging bio-based polymers from lab to market: current strategies, market dynamics and research trends. C, 9(1), 30. https://doi.org/10.3390/c9010030

Kalorama Information. (2021). Laboratory services market (kits, devices, reagents, services). MarketResearch.com.

Kenedi, J., Lanin, D., & Agus, Z. (2018). Analisis pengadaan alat kesehatan di Rumah Sakit Umum Daerah Padang Pariaman tahun 2017. Jurnal Kesehatan Andalas, 7(Suplement 2), 9–16.

Kiehle, J., Kopsakangas-Savolainen, M., Hilli, M., & Pongrácz, E. (2023). Carbon footprint at institutions of higher education: The case of the University of Oulu. Journal of environmental management, 329, 117056. https://doi.org/10.1016/j.jenvman.2022.117056

Koers, M. (2021). Stronger together? A study on the ways to quantify savings achieved by collective procurement in organizations for nursing, care, and homecare (Master's thesis, University of Twente).

Koers, M. (2021). Stronger together? A study on the ways to quantify savings achieved by collective procurement in organizations for nursing, care, and homecare (Master's thesis, University of Twente).

Krah, N. S., Zietzsch, P., Salrach, C., Toro, C. A., Ballester, M., Orrego, C., & Groene, O. (2023, August). Identifying factors to facilitate the implementation of decision-making tools to promote self-management of chronic diseases into routine healthcare practice: a qualitative study. In Healthcare (Vol. 11, No. 17, p. 2397). MDPI. https://doi.org/10.3390/healthcare11172397

López Yeste, M. L., Pons Mas, A. R., Guiñón Muñoz, L., Izquierdo Álvarez, S., García, F. M., Blanco Font, A., ... & Álvarez Domínguez, L. (2021). Management of post-analytical processes in the clinical laboratory according to ISO 15189: 2012. Considerations about the management of clinical samples, ensuring quality of post-analytical processes, and laboratory information management. Advances in Laboratory Medicine/Avances en Medicina de Laboratorio, 2(3), 373-380. https://doi.org/10.1515/almed-2021-0044

Marini, E., & Rochmah, T. N. (2014). Cost benefit analysis mendirikan laboratorium klinik sederhana mandiri dibanding kerjasama operasional laboratorium luar di PLK-UA. Jurnal Administrasi Kesehatan Indonesia, 2(2), 120–127.

Meikaruniawati, S., Setiadi, A. S., & Handono, D. S. (2017). Evaluasi kerjasama operasional pengadaan alat laboratorium otomatisasi di RSUP Nasional Dr. Cipto Mangunkusumo tahun 2009–2015 [Tesis S2, Universitas Gadjah Mada].

Nuryadi, A. R. (2010). Cost benefit analysis (CBA) dalam pengadaan alat CT-scan antara pembelian tunai dibandingkan dengan sistem KSO di RS Siti Khodijah Sidoarjo [Tesis, Universitas Airlangga].

Plebani, M. (2024). Harmonizing the post-analytical phase: focus on the laboratory report. Clinical Chemistry and Laboratory Medicine (CCLM), 62(6), 1053-1062. https://doi.org/10.1515/cclm-2023-1402

Purwanti, R., Sudarto, & Rusmana, O. (2022). Penerapan metode activity based costing dalam perhitungan unit cost sebagai metode alternatif pada penentuan tarif pemeriksaan laboratorium dan radiologi (Studi kasus di RSOP). Jurnal Ekonomi, Bisnis dan Akuntansi (JEBA), 24, 74–97. https://doi.org/10.32424/jeba.v24i3.11580

Racca, G. M. (2010). Collaborative procurement and contract performance in the Italian healthcare sector: illustration of a common problem in European procurement. Public Procurement Law Review, (3), 119.

Rachmawati, B., Retnoningrum, D., & Ariosta. (2018). Manajemen laboratorium klinik seri VII: Improving the quality of laboratory management in daily practice (1st ed.). Fakultas Kedokteran Universitas Diponegoro.

Rohmatullah, F. P., & Susanto. (2018). Analisis perbandingan pengadaan alat pemeriksaan darah di instalasi laboratorium Rumah Sakit Nur Hidayah [Skripsi, Universitas Muhammadiyah Yogyakarta]. Fakultas Kedokteran dan Ilmu Kesehatan.

Ruredzo, P. M., Chale-Matsau, B., Davison, G. M., & Erasmus, R. T. (2023). Moving towards a value-added procurement process in the medical laboratory in Africa. The Journal of Medical Laboratory Science and Technology of South Africa, 5(1), 46-51. http://dx.doi.org/10.36303/JMLSTSA.147

Silapurna, E. L. (2023). Prevention of fraud in the implementation of procurement of goods and services at RSD Idaman Banjarbaru in the time pandemic Covid-19. Journal of Management Science (JMAS), 6(3), 315-323. https://doi.org/10.35335/jmas.v6i3.251

Sitorus, R. (2019). The analysis of cost reduction strategy in laboratory equipment procurement using KSO (Study case in Indonesia University). Journal of Physics: Conference Series, 1192(1), Article 012016. https://doi.org/10.1088/1742-6596/1192/1/012016

Thakur, V., Akerele, O. A., & Randell, E. (2023). Lean and Six Sigma as continuous quality improvement frameworks in the clinical diagnostic laboratory. Critical Reviews in Clinical Laboratory Sciences, 60(1), 63-81. https://doi.org/10.1080/10408363.2022.2106544

Thue, G., & Sandberg, S. (2015). Analytical performance specifications based on how clinicians use laboratory tests. Experiences from a post-analytical external quality assessment programme. Clinical Chemistry and Laboratory Medicine (CCLM), 53(6), 857-862. https://doi.org/10.1515/cclm-2014-1280

Thurow, K., & Junginger, S. (2022). Devices and systems for laboratory automation. John Wiley & Sons.

Vernooij, E. (2021). Infrastructural instability, value, and laboratory work in a public hospital in Sierra Leone. Medicine Anthropology Theory, 8(2), 1-24. https://doi.org/10.17157/mat.8.2.5167

Published
2025-07-30
How to Cite
Kemalayanti, N., Firdawati, F., & Semiarty, R. (2025). Analysis of Determinants of Laboratory Equipment Operational Cooperation System Based on Cost Benefit Analysis in Hospital Management Perspective in X . Journal La Medihealtico, 6(4), 918-935. https://doi.org/10.37899/journallamedihealtico.v6i4.2319