[Cost performance and TQC in laboratory management from the aspect of a commercial laboratory]

Whereas per capita national income in 1992 remained in 0.3% increase, national fee for medical treatment showed a remarkable increase of 7.6% compared with that of the previous year. A recent technological innovation in laboratory medicine such as nonisotopic immunoassays, biosensors and DNA techniques is another factor to rise up the medical expense. Hospital administrator and laboratory manager must consider the most effective laboratory management according to complexity grading of tests. Nowadays, large numbers of test items are ordered from hospitals or clinics to reference laboratories because of cost-analysis for environmental security, heavy instrumentation, problem for bio-hazards and employee fee, etc. Since 1992, when commercial laboratories were allowed legally to be stationed in hospitals as called "branch laboratories", hospital administrators have been in consideration to introduce this system. Commercial laboratories, on the other hand, have come to be obliged to build a laboratory network from branch laboratory through regional laboratory to main reference laboratory with a strict responsibility of TQA including collecting specimens, transportation, receipt, testing and reporting results with on-line computer system. The most important task in the laboratory site is protection of privacy of patient informations, since recent systematization of laboratory tests has led any person working in medical record office and laboratories to easy access to work stations.