[Diagnostic costs of various symptoms and disease pictures]

Diagnostic costs have been investigated in a prospective study based on symptoms and diagnoses of 1000 patients of the medical outpatient clinic. The two most common reasons for consultation were abdominal and chest complaints and diseases of the cardiovascular and digestive system respectively. The most frequent cases concerned patients without definitive diagnosis (i.e. diarrhea of undetermined origin). When costs of diagnostic procedures were grouped according to symptoms constipation and abdominal complaints ranged first with costs of 880 SFr. If costs were determined on the basis of the definitive diagnosis duodenal and gastric ulcers and pneumonia were the most expensive (ca. 1000 SFr), common cold or upper airway infections the cheapest diagnoses (ca. 400 SFr). Both methods for cost estimate either according to symptoms or according to diagnosis had high variances. The maximal expense was in some examples 50 times higher than the minimal cost. These results show that diagnostic costs can not be determined in advance and that flat rates per case are problematic.