The cost-effectiveness of routine pathology consultation in knee arthroscopy.
Regulations in Ontario, Canada, as in most provinces and states in North America, require human tissues (with few exceptions) removed at surgery to be sent to a pathology laboratory for examination and report.
We hypothesized that this practice is inconsistently followed and that routine pathological consultation is costly and rarely results in a change in treatment for patients undergoing knee arthroscopy.
Chiefs of pathology, orthopaedic surgeons, and orthopaedic operating room nurse managers in Ontario hospitals that perform arthroscopic knee surgery were surveyed for compliance.
We determined cost using pathology department procedure codes and evaluated effectiveness as the correlation between the postoperative diagnoses of orthopaedic surgeons and pathologists for 1,036 consecutive knee arthroscopy cases.
In only one case (0.1%) was it felt that pathology consultation had the potential to significantly alter patient care.
The total cost of pathology consultation for the 1,036 cases reviewed was $234,147.00 (mean cost per case, $226.00).
Ninety percent of hospitals do not comply with the regulations regarding the processing of these tissues.
Poor compliance is justified by the lack of diagnostic value and the need to contain health care costs.
Mots-clés Pascal : Arthroscopie, Genou, Technique, Diagnostic, Exploration, Histopathologie, Epidémiologie, Analyse coût efficacité, Homme, Genou pathologie, Membre inférieur, Endoscopie, Système ostéoarticulaire pathologie
Mots-clés Pascal anglais : Arthroscopy, Knee, Technique, Diagnosis, Exploration, Histopathology, Epidemiology, Cost efficiency analysis, Human, Knee disease, Lower limb, Endoscopy, Diseases of the osteoarticular system
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0499825
Code Inist : 002B24E05. Création : 19/02/1999.