价值等于结果/成本:如何应用于检验医学。

IF 3.7 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY
Rossella Tomaiuolo, Giuseppe Banfi
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引用次数: 0

摘要

价值的概念被定义为每单位货币支出所取得的健康成果,它深刻地重塑了现代医疗保健服务。虽然基于价值的医疗保健模式已经渗透到许多临床学科,但实验室医学在整合这种范式转变方面进展缓慢。在这篇观点论文中,我们主张将临床实验室作为医疗保健系统价值的核心推动者进行战略重新定位。长期以来被认为是辅助性的实验室诊断应重新定义为支持基于结果的、具有成本效益的决策的关键工具。我们探讨了实验室参数如何通过预测准确性、诊断特异性和操作适宜性(直接影响患者预后和资源分配的因素)对临床价值做出贡献。例如,维生素D检测、白蛋白作为生物年龄的生物标志物,以及心力衰竭中的NT-proBNP,都证明了容量驱动实验室利用的潜力和缺陷。除了技术卓越之外,我们还强调解释性合作、健康素养和诊断资源的道德管理的重要性。结构性挑战,包括商品化,通过护理点检测的本地化,以及在实验室环境中限制使用患者报告的结果,都被严格审查。最后,我们强调了欧洲新兴的政策框架,将报销模式与可衡量的结果结合起来,倡导将实验室整合到临床治理和基于价值的采购中。在这种新的视角下,实验室不仅仅是数据提供者,而且是个性化、可持续和以患者为中心的护理的代理人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Value is equal to outcome/costs: how to apply to laboratory medicine.

The concept of value, defined as health outcomes achieved per monetary unit spent, has profoundly reshaped modern healthcare delivery. While Value-Based Healthcare models have permeated many clinical disciplines, laboratory medicine has been slow to integrate this paradigm shift. In this opinion paper, we argue for a strategic repositioning of clinical laboratories as core enablers of value in healthcare systems. Laboratory diagnostics, long considered ancillary, should be reframed as pivotal tools that support outcome-based, cost-effective decision-making. We explore how laboratory parameters contribute to clinical value through predictive accuracy, diagnostic specificity, and operational appropriateness - factors that directly influence patient outcomes and resource allocation. Examples such as vitamin D testing, albumin as a biomarker of biological age, and NT-proBNP in heart failure demonstrate the potential and pitfalls of volume-driven laboratory utilization. Beyond technical excellence, we emphasize the importance of interpretive collaboration, health literacy, and ethical stewardship of diagnostic resources. Structural challenges, including commoditization, delocalization via point-of-care testing, and the limited use of patient-reported outcomes in laboratory settings, are critically examined. Finally, we highlight emerging policy frameworks across Europe that align reimbursement models with measurable outcomes, advocating for the integration of laboratories in clinical governance and value-based procurement. In this renewed perspective, laboratories are not merely data providers but agents of personalized, sustainable, and patient-centered care.

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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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