[Cooperations between biology laboratories of the establishments of healthcare]. / Coopérations entre laboratoires de biologie médicale des établissements de santé

In France, the cooperations between biological laboratories of the healthcare establishments increased after those realized in the private laboratories. The biologists are confronted with various hypotheses of organization. They are often complex because they may preserve the quality of the care and their continuity while realizing financial economies. These economies are mostly based on the global reduction in the staff and in the equipments by mutualising the biological tests with varying degrees. We describe the various elements to be taken into account (staff, activities, budget, quality, transport, materials) and propose many scenarios of cooperations, from a unique central shape to the transfer of very specialized tests, with their advantages and their inconveniences. The management of human aspects in these cooperations is determining to facilitate their success as well as a reliable preliminary inventory of fixtures.

[The patient billing cost in medical biology: advantages and disadvantages]. / La facturation coût-patient en biologie médicale: avantages et inconvénients.

Control of health expenditures in relation with staff reduction have led hospital or private labs to seek out growing productivity associated with limited costs. Consolidation and harmonization of equipment have to be implemented, as well as work positions, with the aid of computers. Analytical and preanalytical choices often converge towards the same manufacturer, and it is tempting to simplify also order, receipt and invoicing procedures. This cost optimization requires invoicing taking into account real activity of the lab, establishing "pay per patient" rather than "pay per kit". These changes may also apply to smaller analyzers such as those employed for haemostasis that are deployed in several sites, in aim to reduce costs. We describe the principles of this new mode of invoicing proposed by Roche Diagnostics, for which one may bring out main advantages and inconveniences.