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Related Experiment Videos

Factors affecting laboratory test use and prices.

P M Danzon, W G Manning, M S Marquis

    Health Care Financing Review
    |February 4, 1985
    PubMed
    Summary
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    Reimbursement policies significantly influence clinical laboratory test utilization. Healthcare financing affects testing volume via patient contacts, not per-patient test rates, while fee ceilings may increase test prices.

    Area of Science:

    • Health economics
    • Clinical laboratory science
    • Healthcare policy

    Background:

    • Clinical laboratory test utilization has more than doubled in the past decade.
    • Concerns exist regarding excessive test growth attributed to current payment systems.

    Purpose of the Study:

    • To examine the effects of current reimbursement policies on laboratory test utilization and pricing.
    • To understand how healthcare financing impacts the volume and cost of clinical laboratory tests.

    Main Methods:

    • Analysis of healthcare financing methods, including cost sharing and prepaid group practice.
    • Examination of fee structures for physician services and hospital laboratory charges.
    • Assessment of the relationship between reimbursement policies and laboratory test volume and prices.

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    Main Results:

    • Healthcare financing impacts laboratory test volume primarily through the number of patient contacts with the medical system, not the number of tests per contact.
    • Fee ceilings on physician time appear to be partially counteracted by increased test prices.
    • Cost-based reimbursement for hospital services correlates with higher charges within hospital laboratories.

    Conclusions:

    • Reimbursement policies are a key determinant of clinical laboratory test utilization patterns.
    • Healthcare payment systems influence both the volume and cost of laboratory testing.
    • Further investigation into payment system impacts on laboratory services is warranted.