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- Title
An Essential Pathology Package for Low- and Middle-Income Countries.
- Authors
Fleming, Kenneth A.; Naidoo, Mahendra; Wilson, Michael; Flanigan, John; Horton, Susan; Kuti, Modupe; Lai Meng Looi; Price, Chris; Ru, Kun; Ghafur, Abdul; Jianxiang Wang; Lago, Nestor; Looi, Lai Meng; Wang, Jianxiang
- Abstract
<bold>Objectives: </bold>We review the current status of pathology services in low- and middle-income countries and propose an “essential pathology package” along with estimated costs. The purpose is to provide guidance to policy makers as countries move toward universal health care systems.<bold>Methods: </bold>Five key themes were reviewed using existing literature (role of leadership; education, training, and continuing professional development; technology; accreditation, management, and quality standards; and reimbursement systems). A tiered system is described, building on existing proposals. The economic analysis draws on the very limited published studies, combined with expert opinion.<bold>Results: </bold>Countries have underinvested in pathology services, with detrimental effects on health care. The equipment needs for a tier 1 laboratory in a primary health facility are modest ($2-$5,000), compared with $150,000 to $200,000 in a district hospital, and higher in a referral hospital (depending on tests undertaken). Access to a national (or regional) specialized laboratory undertaking disease surveillance and registry is important. Recurrent costs of appropriate laboratories in district and referral hospitals are around 6% of the hospital budget in midsized hospitals and likely decline in the largest hospitals. Primary health facilities rely largely on single-use tests.<bold>Conclusions: </bold>Pathology is an essential component of good universal health care.
- Subjects
PATHOLOGY; MEDICAL care; ECONOMIC research; DEVELOPING countries; HOSPITAL laboratories
- Publication
American Journal of Clinical Pathology, 2017, Vol 147, Issue 1, p15
- ISSN
0002-9173
- Publication type
journal article
- DOI
10.1093/ajcp/aqw143