概括
增加诊断测试密切跟踪下游程序. 管理诊断测试可能有助于控制不断增加的治疗干预措施,为医疗保健决策提供了洞察力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床决策 临床决策
- 医学经济学 医学经济学
背景情况:
- 在美国,诊断测试的数量大幅增加.
- 诊断测试与随后的治疗干预之间的关系需要检查.
- 了解这种关系可以为医疗保健管理策略提供信息.
研究的目的:
- 调查特定诊断试验与相应的治疗干预措施之间的关联.
- 评估诊断测试使用对治疗程序率的影响.
- 探索管理诊断测试的潜力,以影响治疗干预趋势.
主要方法:
- 使用的医疗保险国家索赔历史和B部分文件 (1987-1993).
- 分析了每年大约3000万美国老年人的医生索赔.
- 治疗干预的回归年率对选定的诊断测试的率,检查五个特定的对.
主要成果:
- 诊断测试的年率显著增加 (1.4至3.0倍).
- 诊断测试率强烈预测了五对患者的治疗干预率 (R2>0.80,P<.01),包括心脏导管/再血管和乳房影像/乳房活检.
- 腹部超声速率与胆囊切除术或大动脉动脉瘤修复率没有相关性.
结论:
- 在美国,诊断测试的显著增加与临床相关下游程序的增加并行.
- 管理诊断测试为控制治疗干预的升级提供了一个可行的策略.
- 这项研究强调了医疗保健资源利用决策的早期阶段的重要性.
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