External quality assessment in clinical chemistry: Review of the situationin Croatia with particular reference to equipment

The effect of the use of new flame photometers (Ciba Coming 480, Chiron, Sa lzburg, Austria) and multichannel analyzers (BM Hitachi 904 or BM Hitachi 9 11, both Boehringer GmbH, Mannheim, Germany) on analytical quality was asse ssed in a number of medical biochemical laboratories (n=58) at health cente rs and general hospitals that provide primary health care services for the respective catchment areas. The laboratories were supplied during 1996 and 1997 with new equipment, as part of the First Croatian Health Project, Primary Health Care Subproject, carried out by the Croatian Ministry of Health and Croatian institute of He alth Insurance. We evaluated analytical performance of these laboratories for 19 analytes, according to the results reported in the Croatian External Quality Assessme nt Program for medical biochemical laboratories, performed four times per y ear. Changes of percentages of particular methods used by the participating labo ratories were observed for inorganic phosphate, total bilirubin, urea and c reatinine. Such changes were even more pronounced for enzymes, where change s in the measurement procedure such as incubation temperature and buffers w ere observed in the methods used. Evaluation of method performance revealed that after the introduction of ne w equipment interlaboratory variation decreased, so that an increasing prop ortion of laboratories included in the Project produced results within the target limits.