まとめ
診断検査の増加は,下流の手順を密接に追跡した. 診断検査の管理は,治療介入の増大を制御するのに役立ち,医療の意思決定に関する洞察を提供することができます.
科学分野:
- 医療サービス 研究 医療サービス
- 臨床的意思決定 臨床的意思決定
- 医学経済学 医学経済学
背景:
- 診断検査は米国で大幅に増加しています.
- 診断検査と,その後の治療介入の関係については,検討が必要です.
- この関係を理解することで,医療管理戦略を策定することができます.
研究 の 目的:
- 特定の診断検査とそれに対応する治療介入の関連性を調査する.
- 治療的処置率に対する診断試験利用の影響を評価する.
- 治療介入の傾向に影響を与えるための診断検査の管理の可能性を探求する.
主な方法:
- 使用したメディケア・ナショナル・クレーム・ヒストリーとパートBファイル (1987-1993)
- 毎年約3000万人の高齢アメリカ人に対する医師の請求を分析した.
- 5つの特定のペアを調査した,選択された診断テストの比率に対する治療的介入の年間比率の回帰.
主要な成果:
- 診断検査の年間比率は (1.4~3.0倍) 大きく増加した.
- 診断テストの割合は,5組 (R2>0.80,P<0.01) の治療介入率を強く予測し,心臓カテーテリゼーション/再血管化およびマンモグラフィー/乳房生検を含む.
- 腹部超音波の頻度はコレシステクトミーや大動脈動脈瘤の修復率と相関しませんでした.
結論:
- 米国における診断検査の有意な増加は,臨床的に重要な下流処置の増加に並行しています.
- 診断検査の管理は,治療介入のエスカレーションを制御するための実行可能な戦略です.
- この研究は,医療資源の利用における意思決定の初期段階の重要性を強調しています.
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