The effect of price information on test-ordering behavior and patient outcomes in a pediatric emergency department.
We sought to determine whether information on hospital charges (prices) would affect test-ordering and quality of patient care in a pediatric emergency department (ED).
Prospective, nonblind, controlled trial of price information.
Urban, university-affiliated pediatric ED.
We prospectively assessed patients 2 months to 10 years of age with a presenting temperature >=38.5°C or complaint of vomiting, diarrhea, or decreased oral intake.
The assessments were done during three periods : September 1997 through December 1997 (control), January 1998 through March 1998 (intervention), and April 1998 (washout).
In the control and washout periods, physicians noted tests ordered on a list attached to each chart.
In the intervention period, physicians noted tests ordered on a similar list that included standard hospital charges for each test.
Records of each visit were reviewed to determine clinical and demographic information as well as patient disposition.
In the control and intervention periods, families of nonadmitted patients were interviewed by telephone 7 days after the visit.
When controlled for triage level, vital signs, and admission rates, in a multivariate model, charges for tests in the intervention period were 27% less than charges in the control period.
The greatest decrease was seen among low-acuity, nonadmitted patients (43%). (...)
Mots-clés Pascal : Diagnostic, Exploration, Biologie clinique, Radiologie, Exploration microbiologique, Imagerie médicale, Examen laboratoire, Analyse coût, Economie santé, Sensibilisation, Pédiatrie, Médecin, Homme
Mots-clés Pascal anglais : Diagnosis, Exploration, Clinical biology, Radiology, Microbiological investigation, Medical imagery, Laboratory investigations, Cost analysis, Health economy, Sensitization, Pediatrics, Physician, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0231293
Code Inist : 002B30A11. Création : 16/11/1999.