Defining the Optimal Size of Medical Laboratories at the Primary Level of Health Care with Data Envelopment Analysis: Defining the Efficiency of Medical Laboratories

INTRODUCTION: As an integral part of health care, biomedical laboratories are an important contributor to quality patient care. There are only few studies on technical and economic efficiency in the field of laboratory medicine. Nevertheless, such research is crucial to further optimize public resources. AIM: The aim of our research is to create and verify a model for defining the scale efficiency of medical laboratories at the primary level of health care. METHODS: Twenty-one laboratories at the primary level of health care in Slovenia were included in the analysis. The efficiency of medical laboratories was determined using data envelopment analysis. We additionally used hierarchical cluster analysis to determine the homogeneous groups within the analyzed sample of units. RESULTS: We determined the high technical and pure technical efficiency of the analyzed laboratories. The analysis results showed that changes in work processes represent only a minuscule improvement in efficiency, while more can be achieved through a proper scaling of laboratory services. The impact of the operating scale on the efficiency of laboratories is up to twice as high as the process inefficiency. If we take into account the operating modes of laboratories, the optimal scale of services starts at 237,570 automatic tests. CONCLUSIONS: We note that increased automation and consolidation of laboratory activities could contribute to a greater efficiency of medical laboratories and consequently reduce public spending. DEA is an appropriate tool for the efficiency analysis of public medical laboratories and of appropriate support for policy creation and evaluation in the field of laboratory medicine.