Mapping Anatomic Pathology Laboratories of Public Hospitals in Greece: Units, Infrastructure, Personnel, and Workload Estimation
Author(s)
Athanassios Vozikis, PhD1, Platon Peristeris, PhD1, Foteini Tsotra, MPH, MSc1, Christina Magkou, MD, PhD2, Anastasios Stofas, MD, PhD3, Dimitrios Bouklas, MD, MSc4, Helen P Kourea, MD, PhD5.
1Laboratory of Health Economics & Management, Economics Dept., University of Piraeus, Piraeus, Greece, 2Pathology Department, Metropolitan Hospital, Neo Faliro, Greece, 3First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 11527, Greece, 4Department of Pathology, General Hospital of Athens "G. Gennimatas", Athens, Greece, 5Department of Pathology, School of Medicine, University of Patras, Patras, Greece.
1Laboratory of Health Economics & Management, Economics Dept., University of Piraeus, Piraeus, Greece, 2Pathology Department, Metropolitan Hospital, Neo Faliro, Greece, 3First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Athens, 11527, Greece, 4Department of Pathology, General Hospital of Athens "G. Gennimatas", Athens, Greece, 5Department of Pathology, School of Medicine, University of Patras, Patras, Greece.
OBJECTIVES: In recent years, Anatomic Pathology Laboratories have faced increasing challenges related to workload, service demand, and tight diagnostic turnaround times. Our study aimed to develop a reliable system to register pathology laboratory workloads along with available human and infrastructural resources.
METHODS: A structured questionnaire was developed following a literature review on assessment practices. A cross-sectional survey was conducted during April 2025 from 55 laboratories across all seven Regional Health Authorities, and data were collected on human resources, age and availability of equipment, as well as their operational condition.
RESULTS: Analysis revealed significant disparities in personnel distribution relative to workload among hospitals and regions (255-2,117 cases/pathologist annually), while 25% of the laboratories were staffed with only one pathologist. Common issues included a lack of secretarial (0.5-1.9 secretaries/hospital) and technician (3.0-5.9 technicians/hospital) support staff, inexistent key roles (e.g. lab supervisor), inconsistent workload documentation methods, and equipment shortages (e.g. ≤1 cryostat microtome/hospital in 2 regions, <1 system of automated immunostaining/hospital in 6 regions). A substantial proportion of devices were outdated (numerous microscopes, balances, and software aged ≥10 years) and did not meet current diagnostic standards, with obsolescence noted in several functional areas. In addition, the current equipment for environmental protection is not deemed sufficient.
CONCLUSIONS: The findings reveal critical imbalances in staffing and issues related to workflow equipment across public Anatomic Pathology Laboratories. The widespread use of outdated devices, coupled with insufficient personnel and non-uniform workload recording practices, undermines diagnostic efficiency and service quality since the medical personnel is called to perform additional to their role tasks. There is an urgent need for standardized monitoring tools (e.g. LIS), targeted investment in both human and technical resources, and map possible laboratory mergers of neighboring hospitals to ensure equitable service delivery and improved patient care outcomes.
METHODS: A structured questionnaire was developed following a literature review on assessment practices. A cross-sectional survey was conducted during April 2025 from 55 laboratories across all seven Regional Health Authorities, and data were collected on human resources, age and availability of equipment, as well as their operational condition.
RESULTS: Analysis revealed significant disparities in personnel distribution relative to workload among hospitals and regions (255-2,117 cases/pathologist annually), while 25% of the laboratories were staffed with only one pathologist. Common issues included a lack of secretarial (0.5-1.9 secretaries/hospital) and technician (3.0-5.9 technicians/hospital) support staff, inexistent key roles (e.g. lab supervisor), inconsistent workload documentation methods, and equipment shortages (e.g. ≤1 cryostat microtome/hospital in 2 regions, <1 system of automated immunostaining/hospital in 6 regions). A substantial proportion of devices were outdated (numerous microscopes, balances, and software aged ≥10 years) and did not meet current diagnostic standards, with obsolescence noted in several functional areas. In addition, the current equipment for environmental protection is not deemed sufficient.
CONCLUSIONS: The findings reveal critical imbalances in staffing and issues related to workflow equipment across public Anatomic Pathology Laboratories. The widespread use of outdated devices, coupled with insufficient personnel and non-uniform workload recording practices, undermines diagnostic efficiency and service quality since the medical personnel is called to perform additional to their role tasks. There is an urgent need for standardized monitoring tools (e.g. LIS), targeted investment in both human and technical resources, and map possible laboratory mergers of neighboring hospitals to ensure equitable service delivery and improved patient care outcomes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD70
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas