title: The number of consultant clinical chemists in the 15-nation European Union.
abstract: The number of consultant clinical chemists (NCCC) in the 15-nation European Union (EU) (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, The Netherlands, Portugal, Spain, Sweden, United Kingdom) has been ascertained. These data were analysed in relation to several established national parameters, including demographics, gross domestic product (GDP), cost of healthcare, cost of in vitro diagnostic (IVD) testing and the number of physicians and pharmacists. Large differences in the population-corrected costs of IVD testing (range approximately 2.4-fold) and NCCC (range approximately 30-fold) were observed between the countries, which could not be satisfactorily explained by any of the parameters assessed. The differences in IVD testing and NCCC might reflect different practices in laboratory medicine across the EU, but could not be estimated independently. In recognition of the different scope of laboratory medicine practised under the title of clinical chemistry, a simple staffing model was derived in an attempt to give a better estimate of the appropriate number of consultant laboratory medicine specialists. This model allocated a fixed number of laboratory specialists per million inhabitants for the five disciplines: clinical chemistry, 10; haematology, 10; serology, 7.5; microbiology, 12.5; and blood banking, 2. The staffing model also allowed for the contribution of the primary care sector by including one full-time consultant laboratory medicine specialist for each small private laboratory and two extra consultant laboratory specialists per million inhabitants where there are not large numbers of private laboratories. Application of the model to the available data helped to reduce the variation observed in the primary analysis of NCCC (range approximately 9-fold) but still revealed important differences between countries. These differences could arise from the poor quality of published data as much as from true differences in laboratory medicine practice. We conclude that a more sophisticated analysis of laboratory practice and of all professionals working in laboratory medicine disciplines would be required before any conclusions could be drawn about relative staffing, efficiency or cost effectiveness. The staffing model derived is a first step towards objective estimation of the number of consultant laboratory specialists in the EU.
authors.affiliation: Department of Clinical Chemistry, IJsselmeerziekenhuizen, Leystad, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Smit
authors.forename: Graham
authors.initials: G
authors.lastname: Beastall
authors.forename: Ulla-Maj
authors.initials: UM
authors.lastname: Bjorses
authors.forename: Mirande
authors.initials: M
authors.lastname: Candito
authors.forename: Piero
authors.initials: P
authors.lastname: Fiorentini
mesh_terms: D002624:Chemistry, Clinical; D003253:Consultants / Q000706:statistics & numerical data*; D005060:Europe; D005062:European Union; D006801:Humans; D017056:Medical Laboratory Personnel / Q000600:supply & distribution*; D015233:Models, Statistical; D000078329:Workforce