Diagnostic management by gatekeepers is not cost effective for neuro-ophthalmology.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 94-0706714
Code Inist : 002B09N. Création : 09/06/1995.