سامانه همایش های دانشگاه آزاد اسلامی واحد نجف آباد

صفحه اصلی / اولین همایش بین المللی تحول خدمات سلامت: تلفیق مراقبت، درمان، بازتوانی و امیدبخشی

From Scattered Benches to Governed Networks: Comparative Lessons in Diagnostic Laboratory Management and a Model for Iran

نویسندگان :

Mehdi Mahdavian Sadr¹ Fatemeh Sadeghi²

1- دانشگاه آزاد علوم تحقیقات 2- دانشگاه آزاد علوم پزشکی تهران

کلمات کلیدی :

Clinical laboratory services،Health services management،Laboratory governance،Laboratory networks،Value-based payment،Iran

چکیده :

Background: Laboratory results inform a large share of clinical decisions, yet laboratories are seldom managed as a system. Iran has more than 8,200 clinical laboratories and a reported volume of about half a billion tests a year, but the sector remains fragmented, priced below cost for some tests and unevenly regulated. Objective: To compare how selected health systems govern diagnostic laboratory services and to propose a model for Iran. Methods: A comparative narrative review of peer-reviewed studies, legislation, regulator reports and official statistics, mostly from 2021 to 2026. England, the United States, Germany, Australia and the stepwise accreditation programme used in sub-Saharan Africa were analysed against seven governance functions: stewardship and regulation, network architecture, financing and payment, quality and accreditation, test stewardship, data and interoperability, and supply chain and workforce. Results: No system performs every function well. England shows what central consolidation into networks can and cannot deliver; the United States regulates analytical quality closely but leaves test use largely to the market; Germany pairs one binding quality guideline with incentives aimed at the ordering doctor; Australia makes accreditation a condition of public payment; and the African programme shows that graded, stepwise improvement works where full accreditation is out of reach. In Iran, below-cost tariffs, small ungraded laboratories, results that do not travel with the patient and sanction-driven supply shocks reinforce one another. Conclusion: We propose a tiered network-and-value model with seven components phased over 2027-2035: an arm's-length steward, provincial hub-and-spoke networks, cost-based and quality-linked payment, star-graded licensing, test stewardship built into e-prescribing, portable results, and a resilient supply chain and workforce.