Retrospective imaging audit and cost analysis of medical oncology inpatients admitted to Westmead Hospital.
Intern Med J
; 44(12a): 1235-9, 2014 Dec.
Article
em En
| MEDLINE
| ID: mdl-25169081
ABSTRACT
BACKGROUND:
Cancer patients often require complex and expensive admissions necessitating multiple investigations. We conducted an audit of cost of imaging performed on medical oncology inpatients in a teaching hospital in New South Wales.AIMS:
Our overall aim was to assess cost and appropriateness of imaging studies in inpatients.METHODS:
Data were collected on 219 consecutive evaluable inpatients admitted to Westmead Hospital (August-October 2012). A panel of oncology doctors assessed cost and appropriateness of imaging.RESULTS:
The total expenditure for the cohort was $106,488.15 over 624 investigations (range 0-26, median two per admission). Of this sum, $8881.91 (8%) was deemed inappropriate. The most frequently ordered test was chest X-ray (251). Imaging cost per admission was $0-2478 (range), $324.95 (median), $486.99 (mean). Cost trended to increase with age of patient ($186.40 (18-40), $477.22 (41-65), $489.50 (66-75), $575.33 (>75) ). Mean cost was higher for patients treated with palliative ($493.98) vs curative ($307.59) intent. Mean cost was higher for patients consulted by palliative care and other subspecialties. There was variation of average cost by discharge destination - other hospital ($262.23), palliative care unit ($334.08), home ($480.84) and death ($769.93). Although imaging ordered was deemed overwhelmingly clinically appropriate, approximately $35,000/year is spent on inappropriate tests, mostly due to duplication or scans that could have been performed as an outpatient.CONCLUSION:
Our audit supports that the current spending patterns on imaging within our department is predominantly appropriate and necessary. Duplication and expenditure may be reduced by improving electronic access from the ward to outpatient scan results.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Diagnóstico por Imagem
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Procedimentos Desnecessários
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Hospitalização
/
Neoplasias
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
/
Male
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Intern Med J
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Austrália