Evolution beyond the shared services model of consolidated hospital clinical laboratories.
OBJECTIVE
To compare the operational and financial outcomes of the transition from shared laboratory services to a recentralized model, in a consolidated hospital system.


METHODS
United Health Services Hospitals (Binghamton General, Wilson Memorial, and Ideal hospitals, New York State).


METHODS
Consolidation of hospital services and recentralization of laboratory testing to a single site (Wilson Memorial Hospital).


METHODS
Laboratory workload, testing efficiency, personnel and nonpersonnel expenses, analytic error rate, turnaround time, and proficiency-testing scores.


RESULTS
The postintervention period (1988 to 1992) was characterized by a 51% and a 10% increase in the out- and inpatient workloads, respectively, with a concomitant 24% increase in testing efficiency. The salary expenses were 26% lower, while the total true cost savings ranged from $1,544,000 (11.6%) to $2,500,000 (21.9%) compared with the shared services model. The recentralization produced decreased analytic error rates and improved testing turnaround time.


CONCLUSIONS
The total costs per test have been lowered in the recentralized model. Recentralization may provide further true cost savings over the shared services model while maintaining high-quality service.
Fattal
G A
GA
Department of Pathology and Laboratory Medicine, United Health Services Hospitals, Binghamton, NY, USA.
Tanasijevic
M J
MJ
Winkelman
J W
JW
D003363:Cost Control; D017048:Health Care Costs; D006801:Humans; D007373:Interinstitutional Relations; D007755:Laboratories, Hospital / Q000191:economics / Q000458:organization & administration*; D010338:Pathology, Clinical / Q000639:trends*; D011785:Quality Assurance, Health Care