private lab testing

The clinical laboratory and the laboratory services which are provided have a major effect on the clinical decisions that physicians, nurses and various other healthcare providers make with patient care. These decisions effect disease prevention, diagnosis, treatment and the management of disease. A surprising number which contrasts the importance that laboratory services provides is the cost which laboratory testing accounts for when looking at healthcare spending.

The latest healthcare statistics show that laboratory services accounts for only 2.3 % of US healthcare expenditures and only 2% of Medicare spending. Consumer directed testing is a key area for market growth. In 2004, 10-15% of hospital and commercial clinical laboratories offered some form of direct access testing.

Laboratories should be prepared to assume a greater advisory role and provide other support to promote informed self care by consumers. Laboratory medicine is an essential element of the health care system. It is integral to many clinical decisions, providing physicians, nurses, and other health care providers with often pivotal information for prevention, diagnosis, treatment, and management of disease. Laboratory tests and services supply clinicians with information necessary to provide high quality, safe, effective, and appropriate care to patients. The key role of laboratory testing is reflected in evidence-based medicine (EBM) and clinical practice guidelines.

Health care providers, quality assurance organizations, and payers are incorporating selected laboratory tests into indicators to objectively assess quality of care for individual patients and populations and to support payment policies. Laboratory medicine has an essential role in risk management. Not only can testing help to prevent certain adverse events, it can facilitate detection and recovery from adverse health events when they do occur.

Laboratory tests help to prevent infectious agents from getting into the blood supply and ensure the safety of organs and tissues for transplant. Through effective and timely surveillance, tests can help to mitigate threats to patient and population health (e.g., influenza, nosocomial infections, severe acute respiratory syndrome). The contributions of laboratory tests and services as an essential component and partner in health systems remain under-recognized.

Despite the extensive role of laboratory medicine in informing medical decision-making, spending on laboratory services accounts for only 2.3% of national health care spending and 2% of Medicare expenditures. As overall expenditures on health care continue to rise, appropriate use of laboratory tests can facilitate cost-effective care via early detection and improved management of priority health conditions. Recent and emerging technological advances gained from mapping the human genome, including applications of genetic testing that enable personalized medicine, call greater attention to the contributions of laboratory medicine to patient care as well as the scientific and medical knowledge base. This chapter summarizes the value of laboratory medicine to health care and patient and population health.