The effect of immediate reading of screening mammograms on medical care utilization and costs after false-positive mammograms.
The effect of immediate reading of screening mammograms on medical care utilization and costs after false-positive mammograms.
复制标题
立即读取筛查性乳房 X 光检查对假阳性乳房 X 光检查后的医疗保健利用和费用的影响。
DOI：
10.1111/j.1475-6773.2006.00660.x
复制
发表时间：
2007
影响因子：
3.4
通讯作者：
Barton,MaryB
中科院分区：
文献类型：
--
作者：
Stewart,KateA;Neumann,PeterJ;Fletcher,SuzanneW;Barton,MaryB
目的：研究乳腺X线检查假阳性的妇女，通过立即阅读筛查照片来降低焦虑是否会降低下游利用率和成本。数据来源/研究设置。我们确定了1,140名年龄≥ 40岁的妇女，在1999年2月至2001年1月期间参加了一项即时与批量乳房X线摄影阅读试验后，假阳性乳房X线摄影和12个月随访。研究设计：我们通过即时和批量阅读状态来确定研究参与者的下游利用率和成本，数据收集/提取方法：人口统计学、合并症和医疗利用率数据来自调查数据和计算机化病历数据库。费用包括直接医疗费用、患者时间、差旅费和共同负担费用，以及与立即阅读相关的额外专业时间成本。主要发现：立即阅读每次筛查乳房X线照片额外花费4.40美元。与批量读数的女性相比，立即读数的女性有更多的随访乳房X线照片（781对750，p= 0.018）和更少的诊断超声（176对219，p= 0.016）。在多变量分析中，乳房护理的健康计划成本比即时读数高出约10%（p= 0.046），但总社会成本没有显著差异（p= 0.072）。结论：即时乳房X线摄影阅读与健康计划成本增加和后续放射学程序的变化相关。这些成本必须与即时阅读的有益效果一起进行研究。
Objective.To investigate whether decreased anxiety associated with immediate reading of screening mammograms resulted in lower downstream utilization and costs among women with false‐positive mammograms.Data Sources/Study Setting.We identified 1,140 women,≥age 40, with false‐positive mammograms and 12‐month follow‐up after participating in a trial of immediate versus batch mammographic reading between February 1999 and January 2001 in a multispecialty group managed care practice in Massachusetts.Study Design.We determined downstream utilization and costs for study participants by immediate and batch reading status.Data Collection/Extraction Methods.Demographic, comorbidity, and medical care utilization data were obtained from survey data and computerized medical record databases. Costs included direct medical costs, patient time, travel and copayments, and additional professional time costs associated with immediate reading.Principal Findings.Immediate reading cost an additional $4.40 per screening mammogram. Women with immediate readings had more follow‐up mammograms (781 versus 750,p=.018) and fewer diagnostic ultrasounds (176 versus 219,p=.016) than women with batch readings. Costs to the health plan for breast care were approximately 10 percent higher for immediate readings in multivariable analyses (p=.046), but no significant difference was seen in total societal costs (p=.072).Conclusions.Immediate mammogram reading was associated with increased costs to the health plan and changes in follow‐up radiology procedures. These costs must be examined alongside beneficial effects of immediate reading.
登录
查看更多内容
影响因子：
39.2
作者：
LERMAN, C;TROCK, B;ENGSTROM, PF
通讯作者：
ENGSTROM, PF
影响因子：
5.7
作者：
Barton, MB;Moore, S;Fletcher, SW
通讯作者：
Fletcher, SW
DOI：
10.1037//0278-6133.10.4.259
发表时间：
1991
期刊：
Health psychology : official journal of the Division of Health Psychology, American Psychological Association
影响因子：
--
作者：
Lerman,C;Trock,B;Rimer,BK;Jepson,C;Brody,D;Boyce,A
通讯作者：
Boyce,A
影响因子：
6.3
作者：
SUTTON, S;SAIDI, G;HUNTER, J
通讯作者：
HUNTER, J
影响因子：
2.6
作者：
BULL, AR;CAMPBELL, MJ
通讯作者：
CAMPBELL, MJ