Use and costs of nonrecommended tests during routine preventive health exams
Use and costs of nonrecommended tests during routine preventive health exams
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DOI：
10.1016/j.amepre.2006.02.003
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发表时间：
2006-06-01
影响因子：
5.5
通讯作者：
Powe, NR
中科院分区：
文献类型：
--
作者：
Merenstein, D;Daumit, GL;Powe, NR
背景资料：预防性健康检查（PHE）的常规办公室访问旨在在早期可治疗阶段识别无症状疾病并影响健康行为。调查包括如何经常进行诊断测试和程序的证据14和指南建议反对在无症状的个人在常规PHEs.Methods，以及与测试和程序相关的费用：在2005年，一个横断面研究办公室为基础的干预措施进行，使用全国门诊医疗服务调查（NAMCS）的数据从1997年至2002年。使用美国预防服务工作组（USPSTF）的建议作为PHE期间诊断干预措施适当性的衡量标准。实验室检查和程序不建议（D排名）包括尿检（UA）;不建议的干预措施包括心电图（EKG）和X射线。结果：订购任何三种诊断干预措施的频率范围从5%到37%，至少有一种干预措施订购43%的时间。三种干预措施的年度直接成本范围从4700万美元到1.94亿美元。结论：减少使用不必要的干预措施可能会消除浪费，提高美国医疗保健的整体质量。
Background: Routine office visits for preventive health exams (PHEs) are designed to identify asymptomatic diseases at early treatable stages and influence health), behaviors. Investigation included how often diagnostic tests and procedures were performed for which evidence 14 and guidelines recommend against in asymptomatic individuals during routine PHEs, and the costs associated with the tests and procedures.Methods: In 2005, a cross-sectional study of office-based interventions was conducted, using National Ambulatory Medical Care Survey (NAMCS) data from 1997 to 2002. Recommendations from the United States Preventive Services Task Force (USPSTF) were used as a measure of appropriateness of diagnostic interventions during the PHE. Laboratory tests and procedures not recommended (D ranking) included urinalysis (UAs); interventions not recommended included electrocardiograms (EKGs) and x-rays.Results: The frequency of ordering any of the three diagnostic interventions ranged from 5% to 37%, and at least one of the interventions was ordered 43% of the time. Annual direct costs for the three interventions range from $47 million to $194 million.Conclusions: Less use of unwarranted interventions will likely eliminate waste and improve the overall quality of health care in the United States.