Managing the demand for laboratory testing: Options and opportunities

The possibilities for ordering laboratory testing in hospitals inevitably need to be managed, given physicians' knowledge on the use of laboratory testing, their attitudes towards test ordering, the constant increase in testing and the limited resources available. On the assumption that some tests may not be strictly necessary or are even redundant, this paper reviews various methods to manage the demand for laboratory tests, evaluating the extent to which these methods are applicable and effective in daily practice. The most promising new management tools seem to be computerised laboratory management systems (CDSS), a reimbursement system based on the diagnosis–treatment combination (as in The Netherlands), and the allocation of laboratory budget to those requesting laboratory services.