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Rhemulatologists' performance in dailiy practice.

S Gorter1, S van der Linden, J Brauer

  • 1Division of Rheumatology, University Hospital Maastricht, The Netherlands.

Arthritis and Rheumatism
|April 20, 2001
PubMed
Summary
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Dutch rheumatologists showed significant variation in resource utilization for common conditions. Experience did not correlate with cost-effectiveness, suggesting a need for appropriateness of care discussions.

Area of Science:

  • Rheumatology
  • Health Services Research
  • Medical Economics

Background:

  • Assessing rheumatologists' clinical performance and resource utilization is crucial for healthcare quality.
  • Understanding factors influencing diagnostic and treatment decisions in rheumatology is essential.

Purpose of the Study:

  • To evaluate the performance of Dutch rheumatologists across eight common rheumatologic conditions.
  • To identify potential factors, such as clinical experience, that explain variations in resource utilization.

Main Methods:

  • 27 rheumatologists were assessed using 8 standardized patients (SPs) simulating common rheumatologic cases.
  • Data collected included SP checklists and simulated resource utilization (lab tests, imaging).
  • Resource utilization costs and checklist scores were analyzed against years of clinical experience.

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Main Results:

  • Significant variation in resource utilization (lab tests and imaging costs) was observed among rheumatologists.
  • Mean costs per visit varied widely, from $4.67 to $65.36 for lab tests and $33.15 to $226.84 for imaging.
  • No significant correlation was found between resource costs and clinical experience or checklist performance; however, more experienced rheumatologists had lower checklist scores.

Conclusions:

  • Considerable variability exists in resource utilization among practicing rheumatologists in the Netherlands.
  • The findings highlight the need for discussions on the appropriateness of care in rheumatology practice.