Valdiguié P M, de Graeve J S, Guerre J P
Laboratoire de Biochimie, Hôpital Universitaire de Rangueil, Toulouse, France.
Clin Chim Acta. 1997 Nov 6;267(1):51-62. doi: 10.1016/s0009-8981(97)00177-0.
The expenses for health care in France have risen considerably during the present decade, ranking third after USA and Canada in the Western world. In spite of the very low cost of laboratory medicine (2.4% of the total expenditure in 1995), clinical laboratories have undergone a severe squeeze, due to two limiting factors; a decrease in the ordering of laboratory tests from private physicians and a reduction in the total expenses for laboratory services from the Social Security. Consequently, there has been unemployment of technical and secretarial staff and severe restriction in investment for buying new equipment. However, hospital laboratories will manage to assume their challenge in developing robotics, automation, molecular pathology techniques and expert systems. Private laboratories, in spite of their efforts to follow the technological advances in automation, will survive thanks to consolidation of regional networks that operate in a cooperative rather than competitive mode. Therefore, the challenge will be not in the adaptation of clinical laboratories, but in the limitation of overspending at the national level and in modification of the behaviour of irresponsible citizens accustomed to spending freely on health care services.
在当前十年间，法国的医疗保健费用大幅上涨，在西方世界仅次于美国和加拿大，位列第三。尽管检验医学成本极低（1995年占总支出的2.4%），但临床实验室仍面临严峻困境，原因有两个限制因素：私人医生开具的检验项目减少，以及社会保障部门用于实验室服务的总费用降低。结果，技术和文秘人员出现失业，购买新设备的投资也受到严格限制。然而，医院实验室将设法应对在开发机器人技术、自动化、分子病理学技术和专家系统方面的挑战。私立实验室尽管努力跟上自动化技术的发展，但由于以合作而非竞争模式运营的区域网络的整合，仍将得以生存。因此，挑战不在于临床实验室的适应，而在于国家层面过度支出的限制，以及改变习惯在医疗保健服务上随意花钱的不负责任公民的行为。
