Keller O, Steurer J, Vetter W
Departement für Innere Medizin, Universitätsspital Zürich.
Praxis (Bern 1994). 1998 Dec 24;87(51-52):1798-804.
Few analyses of the costs of diagnostic plans have been published. We have determined and analyzed the diagnostic costs of 1000 consecutively evaluated patients at the medical outpatient clinic. A data base was developed for this purpose. Based on the itemized tarif the total costs amounted to 622,553.25 SFR. Medical services (consultations) required 20 per cent of this sum, laboratory services and technical investigations 40 per cent each. The average number of consultations per patient was 2.83 +/- 1.85. As expected the first consultation was the most expensive. It amounted on the average to 350.-SFR, 54% of which were used for laboratory and 27% for technical procedures. Chest X-ray, ECG, abdominal ultrasound and upper gastrointestinal endoscopy caused about 20% of the total diagnostic costs. Cost reduction could probably be achieved by using more stringent indications for laboratory and technical services.
关于诊断方案成本的分析鲜有发表。我们已经确定并分析了在医学门诊连续评估的1000例患者的诊断成本。为此建立了一个数据库。根据分项收费标准，总成本达622,553.25瑞士法郎。医疗服务（会诊）占这笔费用的20%，实验室服务和技术检查各占40%。每位患者的平均会诊次数为2.83±1.85次。不出所料，首次会诊费用最高。平均达350瑞士法郎，其中54%用于实验室检查，27%用于技术操作。胸部X光、心电图、腹部超声和上消化道内镜检查约占总诊断成本的20%。通过对实验室和技术服务采用更严格的指征，可能实现成本降低。
