Document Detail

The inappropriate use of imaging studies: a report of the 2004 Intersociety Conference.
MedLine Citation:
PMID:  17411843     Owner:  NLM     Status:  MEDLINE    
The participants of the 2004 Intersociety Conference met to discuss the growing problem of self-referral. The United States spends more of its gross national product on health care than other countries, especially Japan and those in Western Europe. Imaging accounts for a large and growing portion of those costs. Despite spending so much on health care, the United States ranks relatively low in measures of national health, including such parameters as infant mortality and even life expectancy. Because the federal government must keep health care expenditures to a "sustainable growth rate," increases in use are likely to be accompanied by decreases in reimbursement per case. Thus, conference participants agreed that the real problem is inappropriate use, which may arise from (1) ignorance of what specific imaging studies are needed when, (2) high public expectations for imaging tests, (3) the fear of liability for a missed diagnosis (defensive medicine), and (4) self-referral. The Stark laws have been largely ineffective in preventing self-referral because there are many loopholes, and the laws are inconsistently enforced. Among the many potential solutions are the education of our clinical colleagues on appropriateness criteria; the education of the public on the costs of inappropriate use; tort reform; and working with third-party payers, especially the private insurance industry, to develop vigorous privileging programs, to require precertification for self-referred studies, or to establish differential payments for self-referred and non-self-referred imaging.
N Reed Dunnick; Kimberly E Applegate; Ronald L Arenson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the American College of Radiology : JACR     Volume:  2     ISSN:  1558-349X     ISO Abbreviation:  J Am Coll Radiol     Publication Date:  2005 May 
Date Detail:
Created Date:  2007-04-06     Completed Date:  2007-08-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101190326     Medline TA:  J Am Coll Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-6     Citation Subset:  IM    
University of Michigan Health System, Department of Radiology, Ann Arbor, Michigan 48109-0030, USA.
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MeSH Terms
Congresses as Topic
Cost Control
Cost Savings
Diagnostic Imaging / economics,  utilization*
Economic Competition
Health Care Costs
Physician Self-Referral / statistics & numerical data*
Quality Control
Radiology / economics,  statistics & numerical data
Risk Factors
Societies, Medical
United States
Unnecessary Procedures / economics*,  utilization*

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

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