A real-world evidence-based approach to laboratory reorganization using e-Valuate benchmarking data

Pressure to cut health-care costs has involved clinical laboratories underpinning the need to reduce cost per test through programs designed to consolidate activities and increase volumes. Currently, however, there is little evidence of the effectiveness of these measures. The aim of the present study was to verify whether a rational, evidence-based decision-making process might be achieved based on an activity-based cost analysis performed by collecting the data of all variables affecting cost per test.An activity-based costing analysis was performed using a program that provides collected data on performance indicators, benchmark between different laboratories based on performance indicators, and information on reorganization initiatives.The data provided were used in two different settings to (1) verify the results of the internal re-organization of specific protein assay and (2) simulate some scenarios for the reorganization of autoimmune testing in the network of clinical laboratories in a large territory.The data produced by the e-Valuate project enabled the quantification of variation in costs, the utilization of human and technological resources and efficiency, both as final result of a reorganization project (proteins) and as a simulation of a possible future organization (autoimmune tests).