Estimation of Numbers of Testing Personnel and Test Volume in the Clinical Laboratory Improvement Amendments of 1988 Certificate of Accreditation and Certificate of Compliance Laboratories in the United States.

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Yang Xia, Thomas H Taylor, Jufu Chen, Jason Hsia
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Abstract

Context.—: Two major categories of laboratories performing nonwaived testing under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) are the Certificate of Accreditation (CoA) and Certificate of Compliance (CoC) laboratories. Accreditation organizations collect more detailed laboratory personnel information than the Centers for Medicare & Medicaid Services (CMS) Quality Improvement and Evaluation System (QIES).

Objective.—: To estimate total numbers of testing personnel and testing volumes in CoA and CoC laboratories, by laboratory type and state.

Design.—: We developed a statistical inference method by using the respective correlations between testing personnel counts and test volume by laboratory type.

Results.—: QIES reported 33 033 active CoA and CoC laboratories in July 2021. We estimated testing personnel to be 328 000 (95% CI, 309 000-348 000), which is supported by the count of 318 780 reported by the US Bureau of Labor Statistics. There were twice as many testing personnel in hospital laboratories as in independent laboratories (158 778 versus 74 904, P < .001). Independent laboratories had the highest test volume per person, which was twice as high as physician office laboratories (62 228 versus 30 102, P < .001). Hospital and independent laboratories comprised 34% of all CoA and CoC laboratories but performed the largest portion of testing (81%). Physician office laboratories, accounting for 44% of all CoA and CoC laboratories, performed a comparatively low proportion of total tests (9%).

Conclusions.—: Numbers of testing personnel vary considerably by laboratory type and across states. These data can provide valuable insight when assessing laboratory workforce training needs and planning for public health emergencies.

美国 1988 年临床实验室改进修正案》(Clinical Laboratory Improvement Amendments of 1988 Certificate of Accreditation and Certificate of Compliance Laboratories)中检测人员数量和检测量的估算。
背景根据《1988 年临床实验室改进修正案》(CLIA)的规定,进行非豁免检测的实验室主要有两类,即认可证书实验室(CoA)和达标证书实验室(CoC)。与美国医疗保险与医疗补助服务中心(CMS)的质量改进与评估系统(QIES)相比,认可组织收集的实验室人员信息更为详细:按实验室类型和州估算 CoA 和 CoC 实验室的检测人员总数和检测量:我们开发了一种统计推断方法,利用各实验室类型的检测人员数量和检测量之间的相关性进行推断:2021 年 7 月,QIES 报告了 33 033 家活跃的 CoA 和 CoC 实验室。我们估计检测人员为 328 000 人(95% CI,309 000-348 000),美国劳工统计局报告的 318 780 人也支持这一估计。医院实验室的检验人员数量是独立实验室的两倍(158 778 对 74 904,P < .001)。独立实验室的人均检测量最高,是医生办公室实验室的两倍(62 228 对 30 102,P < .001)。医院和独立实验室占所有 CoA 和 CoC 实验室的 34%,但承担的检测任务最多(81%)。医生诊室实验室占所有 CoA 和 CoC 实验室的 44%,但进行的检测占总检测的比例相对较低(9%):结论:不同类型的实验室和不同州的检测人员数量差异很大。这些数据可以为评估实验室人员培训需求和规划公共卫生突发事件提供有价值的见解。
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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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