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Evoked potentials in pediatrics: economic audit
M L Chiozza1, A Suppiej, F Zacchello
1Department of Pediatrics, University of Padua, Padova, Italy.
Insights
Reimbursement for pediatric evoked potential tests, including BAEPs, F-VEPs, and ERGs, is insufficient. Current fees underestimate resource consumption, impacting pediatric services financially.
Area of Science:
- Neuroscience
- Medical Economics
- Pediatric Healthcare
Background:
- Effective resource management is crucial in healthcare.
- Evoked potential examinations are vital diagnostic tools in pediatrics.
- Assessing the economic viability of pediatric diagnostic services is essential.
Purpose of the Study:
- To evaluate the economic efficiency of pediatric evoked potential examinations.
- To identify the discrepancy between healthcare costs and national health service reimbursement.
- To analyze the impact of patient age on resource utilization and test costs.
Main Methods:
- Conducted an economic audit of 59 evoked potential examinations (BAEPs, F-VEPs, ERGs) across pediatric age groups.
- Analyzed test costs, scheduling, and resource consumption.
- Compared actual costs with Italian National Health Service (NHS) reimbursement fees.
Main Results:
- Reimbursement fees from the NHS do not cover the actual costs of pediatric evoked potential tests.
- Resource consumption is underestimated by current reimbursement structures.
- Significant variations in test duration, complexity, and interpretation exist based on pediatric age.
Conclusions:
- Economic audits for pediatric tests must consider age-specific variations and test phases.
- Current reimbursement models based on adult examinations are financially detrimental to pediatric services.
- Age is a critical variable influencing the cost and interpretation of pediatric neurophysiological tests.
Abstract:
In the present era of resource management, there is increasing emphasis on the need to make the best possible use of available resources. We therefore measured the productive factors directly involved in performance of 59 evoked potential examinations (brainstem auditory evoked potentials, BAEPs; flash visual evoked potentials, F-VEPs; and electroretinograms, ERGs) in different pediatric age groups. In order to ascertain the gap between the costs of instrumental examinations performed in our service on children and the fees reimbursed by the Italian national health service (NHS) a breakdown was made of the costs of tests and their scheduling in relation to the different age variables involved. It was found that the fees reimbursed do not cover the real costs, because they underestimate the actual consumption of resources. The findings recorded indicate that for pediatric tests the economic audit should be graded according to the ages of the children examined and should include an analysis of different test phases. The economic audit should also be considered a preliminary step in clinical audit. It is concluded that it is financially punitive to reimburse a pediatric service with a fee based on the examination of adults, because in pediatrics the variable "age" influences the duration and complexity of tests and also their interpretation.