24 hours working plan Increased number of ordered tests ↑↑Pressure on the lab More staffmore reagents ↑↑laboratory budget & Cost of service
“WHO”: Many health systems are underfunded and even the well– funded ones are under economic pressure due to increasing demand and cost inflation. In these scenarios, laboratory services are often accorded low priority and inadequate allocation of “resources.
≈ 70% of health decisions involving laboratory results >10 % total hospital admission tests. ≈ lab cost 24 % hospital bill
Increased # tests? Is it crucial? Responsibility??
Financing Improved health (level & quality) Health Workforce Access Coverage Responsiveness Information Social financial risk protection Medical products & technologies Quality Safety Improved efficiency Service delivery Leadership/Governance WHO Health system Framework; Geneva, WHO , 2007
Assay performance Sensitivity Specificity Reproducibility Supplemental testing Quality assurance Turnaround time Specimen collection Predictive values Specimen type Symptoms gender Instrumentation Throughputs Facilities personnel Cost effectiveness Cost benefit Cost utility Epidemiology Prevalence Clinical setting Risk indicators: Demographic Behavioral and clinical variables Cost Testing costs Non testing cost Selective screening presumptive treatment Consideration for appropriate selection and use of laboratory tests. From Pfister. Reprinted with permission of the university of Wisconsin Board of Regents