Cost Containment in Infection Control: Effect of DRGs on Utilization of the Microbiology Laboratory

Extract

Prospective reimbursement is changing hospital laboratories from profit centers to cost centers. As a result, hospital administrators will try to reduce expenses for operating laboratories. Clinical microbiology could suffer more seriously than other sections because these laboratories are least able to use automation to increase productivity. Both the volume of specimens submitted and the complexity of processing specimens continue to increase in most clinical microbiology laboratories and the only immediate solution, although unlikely, will be increases in personnel. Freezes on replacement hiring and elimination of vacated positions are already occurring in some laboratories. Increased work can be controlled by reducing the numbers of clinically unnecessary specimens that are submitted and the numbers of specimens that are of a type or of such quality that they would not be likely to produce clinically useful information. Secondly, the amount of work expended on certain types of specimens may be reduced both to eliminate unnecessary labor and produce reports that are actually more useful clinically. Eventually changes in the way in which hospitals and physicians are reimbursed may create a greater incentive for physicians to minimize laboratory use. In the meantime, the burden of living within available resources will fall on the clinical microbiologist.