A pathologic diagnosis is usually required to determine definitive management for a palpable lesion.
In this era of cost control, fine-needle aspiration (FNA) provides a low-cost alternative to open excisional biopsy.
Using a broad range of cases collected over 20 years, the authors of this study sought to quantify the savings resulting from the use of FNA on superficial palpable lesions to obtain a pathologic diagnosis.
12,452 cases collected by the cytopathology service at the Medical College of Virginia during the period 1972-1991 were used to produce a profile of case type, diagnosis, and indication for surgery.
Charge-based cost estimations or Relative Value Units were calculated using the 1995 Physicians'Fee Reference or published Medicare participant fees.
The charges for the FNA procedure and open surgical biopsy were compared, and all other biopsy-related costs were omitted.
FNA provided a sufficient pathologic diagnosis to obviate open surgical biopsy in 63-85% of the cases.
Estimation of cost savings on the basis of the distribution of cases and indications for surgery suggested a savings of $250,000 to $750,000 per 1000 FNA performed, or approximately 5500 Relative Value Units.
This study quantifies the substantial savings that result from obtaining a pathologic diagnosis by the FNA procedure rather than open surgical hiopsy.
Mots-clés Pascal : Tumeur, Ganglion lymphatique, Thyroïde, Glande mammaire, Glande salivaire, Biopsie chirurgicale, Ponction aspiration, Aiguille fine, Diagnostic, Homme, Analyse coût, Economie santé, Etude comparative, Endocrinopathie, Thyroïde pathologie, Glande mammaire pathologie, Glande salivaire pathologie, Stomatologie, Chirurgie, Cytopathologie, Anatomopathologie
Mots-clés Pascal anglais : Tumor, Lymph node, Thyroid gland, Mammary gland, Salivary gland, Surgical biopsy, Aspiration punction, Fine needle, Diagnosis, Human, Cost analysis, Health economy, Comparative study, Endocrinopathy, Thyroid diseases, Mammary gland diseases, Salivary gland disease, Stomatology, Surgery, Cytopathology, Pathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0307519
Code Inist : 002B04C. Création : 15/07/1997.