The Use of Transthoracic Echocardiography and Adherence to Appropriate Use Criteria at a Regional Hospital
| Autor: | Jonathan Alexander, Simone Bailey, Joann Petrini, Patricia A. Tietjen, Ionut Mosteanu, Andrew M. Keller |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Myocardial ischemia Appropriate Use Criteria Health care medicine Humans Radiology Nuclear Medicine and imaging Myocardial infarction Practice Patterns Physicians' Hospitals Teaching Intensive care medicine Aged Retrospective Studies Aged 80 and over business.industry Medical record Middle Aged medicine.disease University hospital Regional hospital Connecticut Cardiovascular Diseases Echocardiography Etiology Female Guideline Adherence Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Society of Echocardiography. 25:1015-1022 |
| ISSN: | 0894-7317 |
| DOI: | 10.1016/j.echo.2012.05.014 |
| Popis: | Background The sharp increase in health care costs over the past decade has prompted health care providers to reevaluate how diagnostic imaging is utilized. In response to the need for more rational use of imaging services, the American College of Cardiology Foundation and the American Society of Echocardiography have developed appropriate use criteria (AUC) for transthoracic echocardiography to guide its utilization. Although community and regional hospitals, such as Danbury Hospital, account for 85% of registered hospitals in the United States, very little is known about adherence to the AUC at these institutions. Methods The electronic medical records of 1,205 patients who underwent inpatient transthoracic echocardiography from January 1 to June 30, 2008, were retrospectively examined to determine the reasons for ordering the studies. The 2007 and 2011 AUC were used to classify indications as appropriate, inappropriate, or uncertain. Results Using the 2007 AUC, 86% of echocardiographic examinations were classified as appropriate. One percent had indications that were inappropriate, and there were no uncertain indications. Thirteen percent of studies were ordered for reasons not defined by the 2007 AUC. The most common appropriate indications were symptoms due to suspected cardiac etiology, initial evaluation after acute myocardial infarction, and acute chest pain with suspected myocardial ischemia. When evaluated using the 2011 AUC, appropriate and inappropriate indications increased to 97% and 2%, respectively. Ninety-three percent of undefined studies, using the 2007 AUC, could be classified using the 2011 guidelines. Conclusions Consistent with studies conducted at university hospitals, Danbury Hospital, a regional hospital, showed good adherence to the AUC. This suggests that the AUC are valuable across a large continuum of inpatient settings and can serve as an excellent guide for utilization and appropriateness. |
| Databáze: | OpenAIRE |
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