Feasibility and economic impact of a clinical pathway for pap test utilization in Gynecologic Oncology practice

Gynecologic Oncology
Antonio SantillanRobert E Bristow

Abstract

To evaluate the feasibility and impact on cost to the U.S. healthcare system of implementing a clinical pathway for Pap test utilization in screening and surveillance of gynecologic cancers in a university-based gynecologic oncology practice. Baseline data were collected for Pap test utilization between 1/1/04 and 6/30/05 and prospectively compared to Pap test utilization following the implementation of a clinical pathway (7/1/05 to 5/30/06). The clinical pathway: 1) employed ACOG guidelines for asymptomatic screening of non-cancer patients, 2) allowed testing at 4 months intervals for cervical/vaginal cancer surveillance, 3) limited testing for endometrial cancer surveillance to 2 tests/60 months, and 4) eliminated testing as part of ovarian cancer surveillance. Relevant costs were calculated using Medicare charge-to-cost ratios and adjusted to 2006 USD. For statistical analysis, differences in Pap test utilization and cost were evaluated using student's t-test. During the baseline period, 1725 Pap tests were collected from 5605 ambulatory encounters, for a Pap test rate of 30.8% and an annualized cost of $93,759. After implementation of the clinical pathway, 4209 ambulatory encounters yielded an annual Pap test rate of 11% an...Continue Reading

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Citations

Nov 9, 2011·Journal of the Korean Surgical Society·Sang-Ho JeongHan-Kwang Yang
Aug 10, 2018·Australian Health Review : a Publication of the Australian Hospital Association·Xing Ju LeeSanjeewa Kularatna
Aug 21, 2015·World Journal of Gastroenterology : WJG·Tian-Gen NiBo Li

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