Under the present fee-for-service paying system in medical insurance, over utilization of Services is inevitable leading to financial deficit of medical insurance eventually. Fortunately the government tried to develop Koreanized DRG&PPS for years and we can lock forward to seeing its implementation even though the commencement was postponed to 2001.
Most clinical laboratories in the medical institutions were known as profit centers because they can yield eamings as much according to the amount of order from vanous departments in the Institution. If the DRG/PPS system is in force, the amount of paying for the Services offered to a patient of certain categorized disease will be flat irrespective of the Service volume. Consequently most hospitals will be concerned about the efficiency ever more rendering their Services as less as possible.
Already hospitals are relying on managerial solutions to cut the cost against the coming financial difficules. Arnong the strategies they are pursuing TQM, Restructurmg, Downsizing, Process Improvement, Job redesign and Cultural change can be their major interests.
As a subsystem of the medical institution, the laboratory could be a cost center ineurring more cost if they do more tests for the same patient. Each laboratory has to consider about the situational changes and establish its own strategies based on cost-effective test utilization. The distinct two points will be the effective management and cost-saving in the laboratory.
Now we should try to find possible solutions for the efficient laboratory through TQM, EBM, Standardization of medical care, Critical Path, Downsizing, Restructuring and Reengineering.
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