Managed care organizations may divert skin biopsy specimens to commercial laboratories selected on a cost basis.
Diversion to these laboratories could result in service of decreased quality for the patient and referring physician.
Log-in/log-out dates were collected for all specimens submitted to managed care-authorized laboratories either from a university-based clinic or from a private practitioner's office for a period of 18 months and compared with data obtained from a local dermatopathology laboratory.
A subgroup of specimens containing inflammatory diagnoses or nondiagnostic changes was also examined.
Mean log-in/log-out times were 1.338 days in the dermatopathology laboratory, 6.123 days in managed care-authorized laboratories from the university site, and 7.798 days in managed care-authorized laboratories from a practitioner's office.
The differences between the dermatopathology laboratory log-in/log-out times and thosc of the managed care-authorized laboratories were statistically significant (p<0.0001).
The conclusion from this study is that a quality indicator defined as time from log in to log out revealed a significant increase in interpretation time at managed care-designated laboratories.
Although managed care plans can decrease their financial risk by contracting with national laboratories to provide all services for a set fee, a decreased quality of service can be demonstrated.
Mots-clés Pascal : Examen laboratoire, Critère qualité, Indicateur, Interprétation, Biopsie, Peau, Délai, Traitement, Etude comparative, Secteur privé, Secteur public, Etats Unis, Amérique du Nord, Amérique, Organisation santé
Mots-clés Pascal anglais : Laboratory investigations, Quality criterion, Indicator, Interpretation, Biopsy, Skin, Time lag, Treatment, Comparative study, Private sector, Public sector, United States, North America, America, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0361168
Code Inist : 002B24O01. Création : 12/09/1997.