Wu A H
Department of Pathology and Laboratory Medicine, Hartford Hospital, USA.
Conn Med. 1997 Jan;61(1):15-21.
Reimbursement policies for health-care services in Connecticut and the U.S. have gradually shifted towards fixed reimbursements through implementation of managed care. As a result, there is an increasing need by physicians and other care givers to reduce costs without compromising the quality of the care being delivered. The clinical laboratory is one area where significant cost reductions may be realized. More effective utilization can be accomplished with the elimination of panels of tests, such as the general chemistry profile, removal of antiquated tests or those that provide redundant information, judicious use of drug assays, acceptance of clinical practice guidelines, and use of reflex testing algorithms. Physicians should also focus more on prognostic indicators for disease prevention. Point-of-care testing devices which have higher costs than incremental central laboratory expenses should be used only if it reduces overall operating expenses, as assessed by outcomes analyses. New technologies such as DNA probes can substantially improve diagnostic efficiency. Physicians and clinical laboratories must collaborate to achieve more efficient utilization practices.
康涅狄格州和美国的医疗保健服务报销政策已通过实施管理式医疗逐渐转向固定报销。因此，医生和其他护理人员越来越需要在不影响所提供护理质量的前提下降低成本。临床实验室是一个可以实现大幅成本降低的领域。通过取消检测项目组合（如常规化学检查）、去除过时或提供冗余信息的检测项目、合理使用药物检测、接受临床实践指南以及使用反射检测算法，可以实现更有效的利用。医生还应更多地关注疾病预防的预后指标。只有通过结果分析评估显示即时检验设备能降低总体运营成本时，才应使用成本高于中央实验室增量费用的即时检验设备。DNA探针等新技术可以大幅提高诊断效率。医生和临床实验室必须合作以实现更高效的利用实践。
