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  1. Diagnostic management by gatekeepers is not cost effective for neuro-ophthalmology.

    Article - En anglais


    To determine whether the « gatekeeper physician system » for evaluating neuro-ophthalmologic problems is cost effective.


    The authors retrospectively reviewed the records of 588 patients referred for neuro-ophthalmologic evaluation between July and December 1989 to determine the frequency and cost of unnecessary diagnostic testing ordered by « gatekeeper physicians. » Pre-referral diagnostic testing costs were compared with the cost of neuroophthalmologic consultation for four common problems :

    • (1) optic neuropathy ;

    • (2) diplopia ;

    • (3) ptosis ;

    • and (4) proptosis.


    Between 16% and 26% of patients in the first three diagnostic categories were subjected to overtesting, resulting in $57,900 of excessive costs, a 724% overcharge.

    Mots-clés Pascal : Coût, Etats Unis, Amérique du Nord, Amérique, Système santé, Ophtalmologie, Test clinique, Diagnostic, Economie santé

    Mots-clés Pascal anglais : Costs, United States, North America, America, Health system, Ophthalmology, Clinical test, Diagnosis, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 94-0706714

    Code Inist : 002B09N. Création : 09/06/1995.