Redesigning clinical laboratory services: Securing efficient diagnoses for New Zealanders

Abstract

This monograph develops an evidence-based redesign plan for a key support service in the country’s health system. It is based on a doctoral thesis that evaluated the impact of market-style health resource control of New Zealand’s clinical laboratory services. The monograph summarises material detailed in the thesis, and extrapolates from it to make the following recommendations for improved cost-efficiency: 1) Competitive contracting as a means of price control for diagnostic laboratory services should be abandoned. 2) Laboratory remuneration should be cost-based and independent of specimen origin. 3) Costing methodology already developed and tested in Australia should be introduced here in order to define remuneration formulae. 4) A Laboratory Service Advisory Committee, representatives of clinical laboratories in both sectors, should provide service-related advice to the Ministry of Health. 5) Regionally representative laboratory committees should be charged with planning and co-ordinating district laboratory services, in the interests of cost-efficiency. 6) Interactive electronic expert systems should be developed in major regional laboratories as a counter to clinical laboratory misuse. 7) Technology retraining programmes aimed at achieving suitable medical laboratory technologist redeployment within the health system should be instated in main centres. Long-term, providers of workforce training should aim at developing greater flexibility in the health technology workforce.