What role do neurologists play in determining the costs and outcomes of stroke patients ?
Background and Purpose Despite growing concern over the large numbers of specialists in the United States, little information is available on how stroke treatment varies by the specialty of the attending physician.
This study compares the costs and outcomes of acute stroke patients by physician specialty, especially between neurologists and other specialists.
Methods We selected a random sample of Medicare patients aged 65 years and older admitted with cerebral infarction between January 1 and September 30,1991, identified from the principal diagnosis on Medicare Provider Analysis and Review records.
All Medicare claims for these patients were extracted from the date of admission through 90 days.
The attending physician was identified as that physician billing for routine hospital visits during the first 7 days of the stay.
Results Neurologists treating stroke patients were significantly more expensive than other physicians but obtained better outcomes.
Ninety-day mortality rates for patients treated by neurologists were significantly lower than those for other specialists.
These cost and outcome differences persisted even after adjustment for patient age, comorbidity, hospital teaching status, and other characteristics. (...)
Mots-clés Pascal : Accident cérébrovasculaire, Coût spécifique, Economie santé, Médecin, Spécialité médicale, Neurologie, Soin, Pronostic, Court terme, Long terme, Homme, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Cérébrovasculaire pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Prise en charge
Mots-clés Pascal anglais : Stroke, Specific cost, Health economy, Physician, Medical specialty, Neurology, Care, Prognosis, Short term, Long term, Human, Nervous system diseases, Central nervous system disease, Cerebral disorder, Cerebrovascular disease, Cardiovascular disease, Vascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0015743
Code Inist : 002B30A05. Création : 21/05/1997.