Abstract
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The system arrangement of laboratory services in Slovenia is rather diversified, because it is financed differently at the primary and at the secondary level. Even though financing laboratory services is mostly linked to financing from the health insurance fund (ZZZS), payment of laboratory services, linked to several models (DRG (diagnosis related group), points, poll tax, etc.), is what partially contributes to the inefficiency of spending resources for laboratory services in Slovenia (e.g. duplications of orders and payments for laboratory services, non-transparent payment of services, prevention of patient transfer between levels of healthcare, etc.). Different systems of financing laboratory services force certain groups to be more efficient in spending funds for laboratory services or to transfer investigations to the secondary level. On the other hand, on the secondary level, probably particularly due to indirect financing through DRG, some laboratories invest in technology, which does not achieve adequate effectiveness of use, because a laboratory is not big enough, does not have qualified professionals, and consequently, prices of their services are higher than it would be appropriate in consideration to the extent of investigations due to higher prices of reagents and laboratory services. Indirectly, the research is going to use the costs of reagents and laboratory services as an indicator of the selected technology, which are the cause of the major part of ineffectiveness of spending resources for laboratory services in Slovenian healthcare. Inadequate use of the selected technology brings higher costs of services, and this consequently causes higher public expenditures for healthcare in Slovenia.
The comparison of prices for laboratory services on the primary and on the secondary level shows significant differences in prices. In certain investigations, the prices can differ from each other by more than 150%. According to the data, in Slovenia, 3.5% of expenditure on healthcare protection is used on average for auxiliary services in healthcare (laboratory services and patient transport). The expenditure is increasing according to the data of the Ministry of Health. In other comparable countries of Central and Eastern Europe the percentage varies, e.g. Czech Republic (12.3%), Croatia (2.7%), Poland (4.7%), and Slovakia (8.3%) (Eurostat, 2017).
In this article, we will present the system of financing laboratory services and compare sources of financing, expenditures of carrying out this activity and prices of services. By that we shall check the following two hypotheses:
- The prices of reagents (which are bound by the selected technology) have the greatest influence on the price of the selected services.
- The manner of financing laboratory services affects the prices of services.
Based on the hypotheses check we will be able to conclude, whether public resources for laboratories can be rationalised through the mechanisms of financing, through the central determination of prices for services or through merging laboratories.
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