Cost-effective medicine: the financial impact that practice guidelines have on outpatient hospital charges in the emergency department

The Journal of Emergency Medicine
S J Guterman, M J VanRooyan

Abstract

The objective of this study was to determine whether specific cost-effective guidelines based on a patient's chief complaint can significantly reduce outpatient hospital charges in the ED. A prospective randomized single-blinded clinical trial was conducted in an urban community hospital ED with a 14,000 annual census. The first phase of the study involved preintervention data collection. The second phase focused on development, physician approval, and implementation of 23 specific cost-effective guidelines, as well as general recommendations for diagnostic tests. The third phase involved postintervention data collection. Results showed that the total outpatient hospital charge decreased by 28% per patient. The laboratory hospital charge decreased by 46% per patient. The radiology hospital charge decreased by 20% per patient. The hospital supply charge and pharmacy charge decreased by 31% per patient and 11% per patient, respectively. In conclusion, cost-effective medicine practiced with specific guidelines, based on a patient's chief complaint, significantly reduces unnecessary diagnostic tests and medical treatments ordered by emergency physicians.

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Citations

Jul 28, 2004·Health Policy·Silvana QuagliniUNKNOWN GLADIS Study Group (Guideline Application for the Decision making in Ischemic Stroke)
Oct 18, 2006·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Eleanor WoodOwen Epstein
Mar 22, 2001·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·A SacchettiM E Moakes
Mar 29, 2003·Journal of Clinical Pathology·G Gopal RaoM L Tillyer
Sep 23, 2011·Clinical Orthopaedics and Related Research·Jeannette P P So, James G Wright

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