Discussion of the practice of centralized multicenter integration of independent medical laboratory test item...

Against the backdrop of China's diagnosis-related groups/disease intervention packet payment reforms, which mandate cost-effective laboratory management, this study explored a subspecialty-based, multicenter integration model for nonurgent testing projects in independent clinical laboratories. The mounting pressure on health care expenditure control necessitates innovative approaches to enhance laboratory efficiency and reduce costs without compromising quality.

This research evaluated the impact of integrating testing programs across 4 independent medical laboratories located in cities S, N, H, and L. The integration was conducted on specialized platforms, including flow cytometry, immunoassays, mass spectrometry, and polymer-ase chain reaction. Nonemergent tests with a report turnaround time exceeding 1 day were centralized through cold-chain logistics for intercity sample transfer. Rigorous data collection and analysis methods were employed to compare the efficiency, cost, and quality of preintegration and postintegration performance.

The integration substantially improved testing efficiency (12.11%-71.34%) and reduced costs by 3.70% to 6.25%. Quality metrics demonstrated notable enhancements, with turnaround delay rates decreasing by 0.06% to 0.98% and refund rates decreasing by 0.0% to 0.01%. These improvements were primarily driven by using regional laboratory expertise and implementing artificial intelligence-driven automation technologies for analytical processes.

The findings of this study clearly demonstrate that multicenter integration is an effective strategy for optimizing resource allocation and achieving scalable and cost-effective laboratory operations. This subspecialty-based integration approach provides a viable and scalable solution for laboratories in various regions worldwide, enabling them to strike a balance among testing efficiency, quality, and cost-effectiveness. It not only addresses the urgent challenges posed by health care payment reforms but also offers actionable recommendations for the optimization of laboratory layouts in low- and middle-income countries.