Test Utilization: Controlling Costs in Reference Laboratory Testing

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Reference laboratory testing has a disproportionately higher cost when compared to routine testing performed in the hospital laboratory. This chapter discusses the magnitude of reference laboratory testing in the United States, why reference laboratory testing is necessary, how to select a reference laboratory, how much reference laboratory testing is used by individual clinical laboratories, and considerations for when to have testing performed by a reference laboratory versus in-house. The variety of strategies used to control reference laboratory testing is discussed.