Primary Care Physician's Use of Echocardiography as a Screening Tool: Survey of Physician Reasoning ♦ 611
| Autor: | Wesley Covitz, Andrew S. Bensky, Robert H. DuRant |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
Referral Heart disease business.industry Echo (computing) Primary care physician medicine.disease Chest pain Pediatrics Perinatology and Child Health Emergency medicine Chi-square test medicine Mitral valve prolapse Screening tool Medical emergency medicine.symptom business |
| Zdroj: | Pediatric Research. 43:107-107 |
| ISSN: | 1530-0447 0031-3998 |
| DOI: | 10.1203/00006450-199804001-00632 |
| Popis: | Although studies have shown that using echocardiography as a screening tool for the presence of congenital heart disease is not cost-effective, primary care physicians continue to do so. In an effort to understand their reasoning, a survey containing questions about their estimation of the cost of cardiology services and their approach to several brief clinical scenarios was sent to 867 pediatricians and family physicians in our area. 489 surveys were returned(56%). Data were analyzed using chi square tests, Cramer's V, Kruskal-Wallis ANOVAs and Spearman's r. 93% of the respondents underestimated the cost of an echo, and 67% overestimated the cost of cardiology referral. In fact, 57% of the respondents estimated that referral was as or more expensive than echo, when in reality echo is 3 to 4 times more expensive. 74% of the respondents felt that it was likely or very likely that a cardiologist would order an echo as part of the evaluation of a child with a murmur, when published studies and an analysis of our own practice pattern have shown that this is not the case. Only 25% said that it was likely or very likely that they would manage a patient with a simple defect (i.e. small VSD) found on echo without cardiology referral, suggesting that the echo is not ordered to avoid the need for specialist referral. Respondents were likely (r=0.43, p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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