Applegate W B, Bennett M D, Chilton L, Skipper B J, White R E
Med Care. 1983 May;21(5):486-96. doi: 10.1097/00005650-198305000-00002.
A cost-containment project was established to determine if a broad educational program that coupled clinical logic with feedback of charges to internal medicine residents in an ambulatory clinic setting could alter behavior. The project was evaluated by comparing charge data from a preintervention comparison year with charge data from the intervention year. Decreases in charges for laboratory procedures occurred in six of the seven diagnostic categories during intervention and were significant (t-test) for four categories. Regression analysis evaluated the influence of the intervention and 12 other variables on charges and demonstrated that the intervention was associated with a mean reduction of lab charges of $ 6.30 (p less than 0.0001) and a mean reduction of total encounter charges of $ 10.36 (p less than 0.01). We conclude that our educational program resulted in a decrease in mean laboratory changes and total charges for ambulatory encounters.
设立了一个成本控制项目，以确定在门诊环境中，将临床逻辑与内科住院医师费用反馈相结合的广泛教育项目是否能够改变行为。通过将干预前对照年的费用数据与干预年的费用数据进行比较来评估该项目。在干预期间，七个诊断类别中的六个类别实验室检查费用有所下降，其中四个类别有显著下降（t检验）。回归分析评估了干预措施和其他12个变量对费用的影响，结果表明，该干预措施使实验室检查费用平均降低了6.30美元（p<0.0001），门诊总费用平均降低了10.36美元（p<0.01）。我们得出结论，我们的教育项目使门诊实验室检查费用均值和总费用均有所降低。
