Document Detail


Using sonography to examine adult patients at an academic medical center: have usage patterns changed with the expansion of managed care?
MedLine Citation:
PMID:  12438022     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study was designed to determine whether significant changes have occurred in the utilization of sonography relative to more expensive cross-sectional imaging techniques in adult patients during a time of increasing reliance on managed care. MATERIALS AND METHODS: Use of sonography was compared with use of CT and MR imaging of the abdomen, pelvis, and retroperitoneum in adult patients in 1993 and 1998 at an academic medical center. Clinicians who requested the greatest number of examinations in both years were surveyed to assess their perception of changes in their practice patterns during the interim. RESULTS: Between 1993 and 1998, the use of sonography relative to the other cross-sectional imaging modalities decreased from 56% to 43% (p < or = 0.001). During the same time, CT use increased from 30% to 41% (p < or = 0.001), and MR imaging use increased from 14% to 16% (p < or = 0.001). Survey responses indicated that potential cost saving was not a major factor in physicians' decisions to use sonography rather than other cross-sectional imaging modalities. CONCLUSION: Sonographic utilization decreased during a 5-year period in which managed care provided an increasingly large proportion of overall reimbursement. Cost did not appear to be a major factor in selection of diagnostic tests. Differences over time in refering clinicians' perception of the relative usefulness of sonography, CT, and MR imaging may have contributed to the change in usage patterns.
Authors:
Marc E Liebeskind; Peter H Arger; Amy Liebeskind; Keith Maston; Curtis Langlotz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  179     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-19     Completed Date:  2002-12-19     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1395-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / pathology,  ultrasonography
Academic Medical Centers / statistics & numerical data*
Adult
Humans
Magnetic Resonance Imaging / utilization
Managed Care Programs / statistics & numerical data*
Pelvis / pathology,  radiography,  ultrasonography
Physician's Practice Patterns
Radiography, Abdominal / utilization
Retroperitoneal Space / pathology,  radiography,  ultrasonography
Retrospective Studies
Tomography, X-Ray Computed / utilization
Ultrasonography / utilization*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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