US healthcare and the impact of the changes in the healthcare system o
n the current and future practice of laboratory medicine are analyzed.
Factors considered include - population and government, healthcare ex
penditure, organization of healthcare delivery (institutions, personne
l, healthcare industry, knowledge-personnel production, financing), th
e impact of managed care, and political and public health issues. The
effect of the changing healthcare scene on laboratories and the conseq
uent cost-containment measures for laboratory medicine are examined, i
ncluding centralization, consolidation, supplier relationships, reengi
neering and automation (total lab automation), expert systems, CQI, an
d the move to point-of-care testing. (C) 1997 Elsevier Science B.V.