Cost Containment in Microbiology

Bartlett, Raymond C.

doi:10.1016/s0272-2712(18)30845-x

Cited by 12 publications

(18 citation statements)

References 11 publications

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“…Technology can be characterized as new, more scientifically complex, and more expensive in comparison to "nontechnology" (43). Westlake (68) (6,28,40,43,65,68). However, it is difficult to determine or quantify the benefit of technologic change and assign dollar costs.…”

Section: Impact Of New Technology On Cost Emergence Of New Technologymentioning

confidence: 99%

“…It has been noted that cost justification of new technology based on reduced staffing may be erroneous. The labor-saving potential of a new technology may be overestimated by the manufacturer or laboratory director, or other costs, such as reagents, maintenance, or replacement equipment, may negate any savings realized as a result of labor reduction and, therefore, must be included in the financial calculations (6,18). McGregor argues that the increased costs associated with technology are proportional to the success of each innovation and that the new technology and its attendant costs permit the treatment of many diseases that formerly were nontreatable (43).…”

Section: Impact Of New Technology On Cost Emergence Of New Technologymentioning

confidence: 99%

“…It has been speculated that this cycle is simply a logical extension of predictive value theory since the discriminatory value of a test is a function of its sensitivity and specificity and of the prevalence of the disease in the study population (51). The microbiology laboratory has shared in the technologic advances experienced in the other areas of the clinical laboratory and has found that conventional methods continue to be used, even when replaced with a new procedure, until the predictive value of the new method is completely understood (6,11). As a result, the technology pool is continually expanding along with exhaustive laboratory test requisition forms and multiple bits of laboratory data that frequently yield conflicting results.…”

Section: Cost Containment Of New Technologymentioning

confidence: 99%

“…After several years, many laboratories collected data that indicated that bacterial antigen detection was seldom more useful than the Gram stain in the detection of untreated bacterial meningitis. Additionally, the predictive value of the latex test for the diagnosis of meningitis in untreated patients with Gram stain-negative, normal spinal fluid has not been established (6). Although new molecular technologies have the potential to enhance the speed, sensitivity, and specificity of microbial detection, these methods will tend to increase rather than decrease costs, especially if they are broadly implemented.…”

Section: Cost Containment Of New Technologymentioning

confidence: 99%

“…By the mid-1970s, escalating federal health care expenditures had become an important political issue (6). The conclusion had been reached that the post-Medicare era had resulted in greater spending with minimal incentives to improve labor or hospital efficiency since any utilization controls or increased productivity served only to diminish third-party payer reimbursement, which was cost based (10).…”

Section: Prospective Reimbursement and Drgsmentioning

confidence: 99%

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Rationale for cost-effective laboratory medicine

Robinson

1994

Clin Microbiol Rev

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There is virtually universal consensus that the health care system in the United States is too expensive and that costs need to be limited. Similar to health care costs in general, clinical laboratory expenditures have increased rapidly as a result of increased utilization and inflationary trends within the national economy. Economic constraints require that a compromise be reached between individual welfare and limited societal resources. Public pressure and changing health care needs have precipitated both subtle and radical laboratory changes to more effectively use allocated resources. Responsibility for excessive laboratory use can be assigned primarily to the following four groups: practicing physicians, physicians in training, patients, and the clinical laboratory. The strategies to contain escalating health care costs have ranged from individualized physician education programs to government intervention. Laboratories have responded to the fiscal restraints imposed by prospective payment systems by attempting to reduce operational costs without adversely impacting quality. Although cost containment directed at misutilization and overutilization of existing services has conserved resources, to date, an effective cost control mechanism has yet to be identified and successfully implemented on a grand enough scale to significantly impact health care expenditures in the United States.

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