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Variability in resource use: diagnosing colorectal cancer
F Douglas Srygley1, David H Abbott, Steven C Grambow
1Division of Gastroenterology, Department of Medicine, Duke University Medical Center, DUMC Box 3913, Durham, NC 27710, USA. douglassrygley@gmail.com
The American Journal of Managed Care
|June 21, 2013
Summary
More diagnostic services for colorectal cancer, including lab tests and imaging, were linked to longer diagnosis times. Resource use varied by patient age and how the cancer was found.
Area of Science:
- Healthcare resource utilization
- Colorectal cancer diagnosis
- Clinical services research
Background:
- Efficient healthcare resource use is critical across all systems.
- Colorectal cancer is a prevalent disease, yet clinical resource utilization for its diagnosis is under-researched.
- Understanding diagnostic patterns is key to optimizing patient pathways.
Purpose of the Study:
- To evaluate patterns and factors influencing clinical service use in diagnosing colorectal cancer within the US Department of Veterans Affairs.
- To determine if increased clinical service utilization correlates with a longer time to diagnosis.
Main Methods:
- Observational study of 449 patients diagnosed with colorectal cancer.
- Analysis of clinical diagnostic services: laboratory tests, imaging studies, and subspecialty consultations.
- Use of cumulative logistic regression to identify factors associated with service utilization.
Main Results:
- Significant facility-level variability in resource use was observed.
- Older patients and incidentally discovered cancers showed higher utilization of diagnostic services.
- A strong positive correlation (Spearman coefficient=0.99) was found between the number of diagnostic services and time to diagnosis.
Conclusions:
- Diagnostic clinical service utilization for colorectal cancer is influenced by patient age, presentation, and healthcare facility.
- Higher resource consumption is strongly associated with a prolonged time to diagnosis, highlighting potential inefficiencies.
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