Evaluation of Biomedical Laboratory Performance Optimisation using the DEA Method.

INTRODUCTION: The Slovenian Resolution on the National Healthcare Plan notes that the country's medical laboratory activities are fragmented, which may result in cost-inefficiency and a reduction in the quality of the services provided. Defining the efficiency of laboratory service providers can therefore help us to pursue the objectives of the Resolution, i.e. to consolidate and integrate laboratory activities. METHODS: Using the DEA method, we conducted an analysis of the efficiency of 20 biomedical laboratories in Slovenia, and made a comparison with a "virtual" laboratory, i.e. a merger of laboratories within a selected organisational unit. By testing different DEA models, we sought to determine whether the use of different input variables caused significant differences in the laboratories' efficiency scores. RESULTS: The research results show that inefficiency resulting from the size of the units is 1.5 times greater than process inefficiency. Using a non-parametric Wilcoxon Signed Rank test, we determined, at a risk level of 0.05, that there was no difference between the efficiency results when using two different technical efficiency DEA models. When evaluating the virtually merged laboratory, we determined that, under all three models, the virtual laboratory achieved 100% VRS efficiency. However, when the CRS methodology was used, the laboratory showed a certain degree of scale inefficiency. CONCLUSIONS: When evaluating merger of medical laboratories we note that the DEA method is methodologically suitable for evaluating the effects of health policy implementation, and is an appropriate tool for identifying where the field of laboratory medicine might be further developed and improved.

Defining the Optimal Size of Medical Laboratories at the Primary Level of Health Care with Data Envelopment Analysis: Defining the Efficiency of Medical Laboratories.

INTRODUCTION: As an integral part of health care, biomedical laboratories are an important contributor to quality patient care. There are only few studies on technical and economic efficiency in the field of laboratory medicine. Nevertheless, such research is crucial to further optimize public resources. AIM: The aim of our research is to create and verify a model for defining the scale efficiency of medical laboratories at the primary level of health care. METHODS: Twenty-one laboratories at the primary level of health care in Slovenia were included in the analysis. The efficiency of medical laboratories was determined using data envelopment analysis. We additionally used hierarchical cluster analysis to determine the homogeneous groups within the analyzed sample of units. RESULTS: We determined the high technical and pure technical efficiency of the analyzed laboratories. The analysis results showed that changes in work processes represent only a minuscule improvement in efficiency, while more can be achieved through a proper scaling of laboratory services. The impact of the operating scale on the efficiency of laboratories is up to twice as high as the process inefficiency. If we take into account the operating modes of laboratories, the optimal scale of services starts at 237,570 automatic tests. CONCLUSIONS: We note that increased automation and consolidation of laboratory activities could contribute to a greater efficiency of medical laboratories and consequently reduce public spending. DEA is an appropriate tool for the efficiency analysis of public medical laboratories and of appropriate support for policy creation and evaluation in the field of laboratory medicine.