title: [International trends in clinical laboratory testing].
abstract: During the 20th century, at least until the 1980s, clinical laboratory practice had been rapidly expanded, mainly because of a significant advancement in medicine as a whole and also in laboratory technology. However, recent economic changes in health care environment worldwide have been influencing greatly future trends in clinical laboratory practice. In 1983, the DRG/PPS was introduced in the Medicare hospital care in the United States, and it will be introduced also in out-patient care after the January of 2000. This payment system has been expanded to the HMO, and a drastic change has occurred in clinical laboratory practice, particularly since 1988 when the CLIA'88 was implemented. In Japan, the DRG/PPS is now in the process of preparing for the future introduction into the National Health Insurance System. The clinical laboratory must pursue both quality management and adequate utilization of laboratory tests. In near future, the ISO standards in clinical laboratory testing will prompt to the implementation of quality management in the clinical laboratory. Evidence-based laboratory medicine or systematic review in diagnostic testing will be introduced in order to improve the utilization of clinical laboratory tests.
authors.affiliation: International Clinical Pathology Center, Tokyo.
authors.forename: T
authors.initials: T
authors.lastname: Kawai
mesh_terms: D019411:Clinical Laboratory Techniques / Q000592:standards*; D003362:Cost-Benefit Analysis; D007753:Laboratories / Q000458:organization & administration / Q000592:standards*