Trends in laboratory utilization in British Columbia hospitals 1966 to 1980 : implications for manpower planning

One might expect that there are a number of factors that influence the demand for laboratory services including changes in population, physician supply, the delivery system, changing technology, and the availability of a skilled workforce. Similarly, the supply of laboratory services is affected by the supply of available manpower, particularly physicians, and the amount of capital flowing into the health care sector of the economy. Trends in the utilization of laboratory services have a substantial impact on manpower use in this sector of the health care system. In order to prepare appropriate manpower projections for laboratory personnel, planners must consider the impact of trends in the above factors. This study presents an analysis of data showing trends in the pattern of laboratory utilization in British Columbia public hospitals from 1966 to 1980 and relates these trends to changes in the above factors. Trends are identified by analyzing utilization data for each of 1966, 1970, 1974, 1978, and 1980. The primary source of data is the HS-1 Health and Welfare Canada statistical returns prepared annually by all hospitals. The analysis involves calculating percentage changes between each period in key utilization measurement parameters. Utilization measurement parameters include patient days per acute care admission, acute care admissions per bed, laboratory workload and expenses per patient day and per acute care admission, and other parameters related to demographics, bed distribution, physician supply, and laboratory manpower supply. This analysis is put into the British Columbia context and discussed in relation to provincial policies and the development of the provincial health care delivery system. Data are presented showing B.C.'s population to be aging and the impact of this trend on laboratory demand is discussed. It is shown that the acute care bed/population ratio decreased from 6.1/1,000 in 1962 to 4.3/1,000 in 1978 while the ratio of extended care beds increased from 0.4/1,000 to 2.2/1,000. It is also shown that there has been a general decrease in hospital activity related to Obstetrical and Pediatric services in B.C. hospitals from 1966 to 1980. Physician supply is reported to have a substantial impact on the use of health care services, including laboratories, and B.C. is shown to have the highest ratio of general practitioners in Canada with one for every 578 people. Automation has permitted more throughout per laboratory worker and helped keep the rise in laboratory operating expenses from increasing proportionately with workload. Laboratory expenses data show an increasing emphasis on supplies and a decreasing emphasis on medical salaries. It was found that there were no large changes in the mix of laboratory personnel employed in B.C. hospitals throughout the period 1966 to 1980. Medical Laboratory Technologists generally comprise about 66% of the laboratory workforce. Technical Assistants account for about 7% of the workforce and clerical staff comprise approximately 23% of the laboratory workforce. Recommendations for improved data collection are made together with some observations related to better development and deployment of laboratory manpower.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat