Laboratory costs and utilization: a framework for analysis and policy design.

A conceptual framework is outlined as the basis for analysis and evaluation of laboratory test-ordering patterns. This framework highlights the input, process, and output phases of the laboratory inquiry system. Data are presented from a contemporary Canadian study to show that the cost of laboratory testing is escalating and represents a sizable proportion of hospital costs. Practical policy interventions intent on reducing the costs in this complex system will require thorough analysis within a conceptual framework such as is outlined here and will require ultimately sophisticated control programs at various levels in the laboratory inquiry system.