Análise do desempenho de laboratórios de análises clínicas acreditados pelo Sistema Nacional de Acreditação no Programa Nacional de Controle de Qualidade

Abstract

The National Quality Control Program (PNCQ) is a Brazilian provider of Proficiency Testing with a vast participation of laboratories. It oversees 5,700 laboratories participating in the proficiency testing program and 474 laboratories accredited by the National Accreditation System. This study aimed to assess the performance of clinical laboratories in PNCQ's proficiency testing program, differentiating between accredited and non-accredited as well as private and public laboratories. The evaluation focused on the results of the PNCQ Biochemistry and Hematology basic programs from October 2021 to September 2022. The data were analyzed using R version 4.1.2 software, calculating absolute risk differences with respective confidence intervals. The study included 4,810 private laboratories and 314 public laboratories, of which 383 were accredited, and 4,741 were non-accredited. A total of 1,088,577 measurements were considered for the Biochemistry, and 494,375 measurements for the Hematology. PNCQ's evaluation process involved calculating mean and standard deviation on a monthly basis, with scoring criteria categorized as Good (B), Acceptable (A), or Inacceptable based on standard deviations from the mean. Accredited laboratories showed a 5.1% higher percentage of A+B results compared to non-accredited laboratories in the Basic Biochemistry program. Similarly, in the Hematology program, accredited laboratories had a 2.1% higher percentage of A+B results compared to non-accredited laboratories. Brazilian public laboratories outperformed private ones, achieving a 3.1% higher percentage of B+A results in the Biochemistry program and 1.0% higher percentage in the Hematology program. Brazilian public laboratories demonstrated better proficiency test results in Biochemistry and Hematology compared to private laboratories (93.1% vs. 90.0% and 95.6% vs. 94.6%, respectively). Additionally, accredited laboratories showed superior participation results in these proficiency tests compared to non-accredited ones (96.9% vs. 89.8% in Biochemistry and 96.7% vs. 94.6% in Hematology).