[More adequate use of laboratory services--economical aspects]. / Riktigere bruk av laboratorietjenester--økonomiske aspekter.

BACKGROUND: There has been a substantial increase in reimbursement for outpatient laboratory services in recent years. This article gives an overview of the use of such laboratory services and discusses measures for improved efficiency. MATERIAL AND METHODS: We have analysed reimbursement to the specialist health care for the period 2002-04. RESULTS: In the period 2002-04 the reimbursement to public laboratories increased by 42%. There has been a substantial growth in all reimbursements groups, especially for "General analysis for molecular biological methods" (236%). Reimbursement to private laboratories have increased by 24%, similar to the increase in general clinical chemistry. There has been a trend towards using the expensive reimbursement groups more often, especially for public laboratories. There is substantial variation in the use of laboratory services between the health regions. DISCUSSION: Our results indicate that the growth and variation in the use of laboratory services cannot be explained by deteriorated health or more illness in the population. The variation indicates that the use of laboratory services is not optimal. Establishment of a national laboratory system within specialized health care may contribute to a more knowledge-based use of laboratory services.

[Appropriate use of laboratory tests--medical aspects]. / Riktigere bruk av laboratorietjenester--medisinske aspekter.

BACKGROUND: There has been a large increase in the use and costs of laboratory tests during recent years. Several reports have indicated excessive and inappropriate use. The purpose of this study was to assess the use of public laboratory services within clinical chemistry in two Norwegian health regions. MATERIAL AND METHODS: Production statistics for 2004 were obtained through a questionnaire sent to all public clinical chemistry hospital laboratories in northern and western Norway. Additional detailed production statistics were obtained from Haukeland University Hospital for 2002-04. RESULTS: We observed differences in the absolute frequency of requested tests and a marked variation in relative ratios (ratio between related tests) between the laboratories in northern and western Norway. Data from Haukeland University Hospital showed a mean increase of 12% (range: -24-54%) in the number of ordered tests between 2002-04. INTERPRETATION: There are no known differences in morbidity between the northern and western health regions that can explain the observed variations in the use of laboratory tests. Our observations indicate a need for a thorough investigation of current utilisation of laboratory tests. Initiatives should be taken on a national basis to improve appropriate use.