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不适当的乳腺影像学检查:成本分析。

Inappropriateness of breast imaging: cost analysis.

机构信息

Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Terapia Radiante, IRCS Policlinico Universitario di Tor Vergata (PTV), Viale Oxford 81, 00133, Rome, Italy,

出版信息

Radiol Med. 2013 Sep;118(6):984-94. doi: 10.1007/s11547-013-0948-5. Epub 2013 Jun 26.

Abstract

PURPOSE

The aim of this study was to assess how an incorrect indication for an examination may affect the diagnostic workup and diagnosis as well as healthcare expenditure.

MATERIALS AND METHODS

We considered all the requests for breast imaging (mammography, ultrasound and magnetic resonance imaging) received by our radiology department between October 2010 and December 2010, and assessed their appropriateness based on the patient's age and the clinical question, if present. We then analysed the unnecessary costs resulting from inappropriate requests.

RESULTS

Out of a total of 1500 requests for ultrasound examination, the request was appropriate in 855 (57%) cases; out of a total of 2350 requests for mammography, the request was appropriate in 493 (21%) cases; out of a total of 100 requests for magnetic resonance imaging, the request was appropriate in 83 (83%) cases. The cost deriving from inappropriate requests was 51,235.04 Euros.

CONCLUSIONS

Improving the timeliness of diagnosis is an important goal to be pursued by enhancing the available health services, improving communication and coordination of the different professionals involved and optimising diagnostic pathways in order to reduce healthcare spending.

摘要

目的

本研究旨在评估检查的错误指征如何影响诊断工作以及诊断和医疗支出。

材料和方法

我们考虑了 2010 年 10 月至 12 月期间放射科收到的所有乳房影像检查(乳房 X 线摄影、超声和磁共振成像)的请求,并根据患者的年龄和存在的临床问题评估其适宜性。然后,我们分析了不必要的请求所产生的不必要的成本。

结果

在总共 1500 次超声检查请求中,855 次(57%)请求是适宜的;在总共 2350 次乳房 X 线摄影请求中,493 次(21%)请求是适宜的;在总共 100 次磁共振成像请求中,83 次(83%)请求是适宜的。不适当请求导致的成本为 51235.04 欧元。

结论

通过增强现有卫生服务、改善不同专业人员之间的沟通和协调以及优化诊断途径以减少医疗支出,提高诊断及时性是一个需要追求的重要目标。

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