Evaluation of Biomedical Laboratory Performance Optimisation Using the DEA Method

Abstract

The Slovenian Resolution on the National Healthcare Plan notes that the country's medical laboratory activities are fragmented, which may result in cost-inefficiency and a reduction in the quality of the services provided. Defining the efficiency of laboratory service providers can therefore help us to pursue the objectives of the Resolution, i.e. to consolidate and integrate laboratory activities. Using the DEA method, we conducted an analysis of the efficiency of 20 biomedical laboratories in Slovenia, and made a comparison with a "virtual"laboratory, i.e. a merger of laboratories within a selected organisational unit. By testing different DEA models, we sought to determine whether the use of different input variables caused significant differences in the laboratories' efficiency scores. The research results show that inefficiency resulting from the size of the units is 1.5 times greater than process inefficiency. Using a non-parametric Wilcoxon Signed Rank test, we determined, at a risk level of 0.05, that there was no difference between the efficiency results when using two different technical efficiency DEA models. When evaluating the virtually merged laboratory, we determined that, under all three models, the virtual laboratory achieved 100% VRS efficiency. However, when the CRS methodology was used, the laboratory showed a certain degree of scale inefficiency. When evaluating merger of medical laboratories we note that the DEA method is methodologically suitable for evaluating the effects of health policy implementation, and is an appropriate tool for identifying where the field of laboratory medicine might be further developed and improved.