On-site colposcopy services in a family practice residency clinic: impact on physician test-ordering behavior, patient compliance, and practice revenue generation
| Autor: | Truc Dinh, Michael D. Prislin, Mark Giglio |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Adult
medicine.medical_specialty Cost-Benefit Analysis Uterine Cervical Neoplasms Primary care Cervix Uteri Ambulatory Care Facilities California Revenue generation medicine Revenue Humans Mass Screening Patient compliance Aged Neoplasm Staging Colposcopy Vaginal Smears medicine.diagnostic_test business.industry Obstetrics and Gynecology Internship and Residency General Medicine Middle Aged Uterine Cervical Dysplasia Patient volume Family medicine Ambulatory Emergency medicine Patient Compliance Female business Family Practice Test ordering Papanicolaou Test |
| Zdroj: | The Journal of the American Board of Family Practice. 10(4) |
| ISSN: | 0893-8652 |
| Popis: | Using colposcopy as a model, we examined the impact of introducing a new diagnostic technology into the ambulatory primary care setting.Records of patients with abnormal findings on Papanicolaou smears were reviewed from three study periods: 1 year before, 1 year after, and 5 years after initiation of on-site colposcopy services. Data analyzed include physician management decisions, site of colposcopic service, and patient compliance. Practice revenue estimates were based upon patterns of physician management and patient compliance found during each study period.Management of low-grade squamous intraepithelial lesions varied during each study period. By period 3, however, most patients were undergoing colposcopy (P = 0.03). High-grade squamous intraepithelial lesions were uniformly managed with colposcopy during all study periods (P0.001). Introduction of on-site colposcopic services resulted in a rapid shift to the on-site location for evaluation of low-grade squamous intraepithelial lesions and a more gradual shift to the on-site location for evaluation of high-grade squamous intraepithelial lesions. Patient compliance was not affected by the introduction of on-site services. On-site colposcopy resulted in a nearly 100 percent transfer of revenue to the practice, but the economic benefit was quite modest.Although offering on-site colposcopy services might have had some impact on physician management of low-grade squamous intraepithelial lesions, the lack of benefit regarding patient compliance, the relatively small patient volume for this procedure, and its modest impact on practice revenue cause us to question the value of including colposcopy in everyday practice. |
| Databáze: | OpenAIRE |
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