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Prospective screening of diagnostic testing: a valuable tool.
1Cornell University Medical College.
Benefits Quarterly
|December 10, 1991
Summary
Prior review of diagnostic tests can effectively reduce medical costs. A pilot study found 21% of tests were inappropriate, highlighting the value of prospective review for screening unnecessary procedures.
Area of Science:
- Health economics
- Medical diagnostics
- Quality improvement
Background:
- Reducing medical costs and enhancing care quality are key healthcare goals.
- Diagnostic tests are often discretionary and can be unnecessary, making them targets for cost-reduction efforts.
Purpose of the Study:
- To prospectively evaluate the appropriateness of diagnostic tests ordered.
- To assess the effectiveness of prior review as a cost-containment strategy for diagnostic testing.
Main Methods:
- A pilot study reviewed diagnostic tests ordered in early 1989 for insured individuals.
- Physician reviewers assessed the propriety of each ordered diagnostic test.
Main Results:
- Physician review identified 21% of diagnostic tests as inappropriate.
- This suggests a significant portion of diagnostic testing may not be medically necessary.
Conclusions:
- Prospective review is an effective method for screening inappropriately ordered diagnostic tests.
- Implementing prior review can help reduce healthcare costs by eliminating unnecessary diagnostic procedures.