磁共振成像在接受全膝关节整形手术的患者中过度使用吗?
Lekya Mukkamala1, Sabina L Schaffer, Matthew G Weber
1From the Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA (Ms. Mukkamala and Ms. Schaffer), and the Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA (Dr. Weber, Dr. Wilde, and Dr. Rosen).
概括
许多全膝关节整形术 (TKA) 患者在咨询前接受不必要的MRI,费用成千上万. 实施基于证据的指导方针可以优化医疗保健利用率,并降低这些膝关节置换患者的成本.
科学领域:
- 整形外科手术 整形外科手术
- 放射学 放射学是一门学科.
- 卫生经济学 卫生经济学
背景情况:
- 医疗保健支出不断增加,需要评估诊断成像的临床必要性.
- 在全膝关节整形术 (TKA) 患者的咨询前磁共振成像 (MRI) 是一个重要的成本驱动因素.
研究的目的:
- 量化在接受TKA的患者中进行的临床上不必要的咨询前MRI的数量.
- 评估在这个患者群体中不必要使用MRI的财务影响.
主要方法:
- 对869名TKA初级患者的医疗记录和成像进行了回顾性审查.
- 根据临床指示和放射性发现,评估咨询前MRI的必要性.
主要成果:
- 在869名TKA患者中,有177名患者 (20.4%) 在咨询前进行了MRI;有112人符合纳入标准.
- 10.0% (87个MRI) 被认为是临床上不必要的.
- 不必要的MRI在该机构每年估计花费20,706美元.
结论:
- 转诊医生在对TKA患者进行骨科咨询之前过度使用MRI.
- 过度使用MRI带来了巨大的财务负担,突显了改善医疗保健资源配置的必要性.
- 实施基于证据的指导方针对于优化MRI利用和降低TKA患者护理成本至关重要.
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