Diagnostic test use in different practice settings. A controlled comparison

Journal Article · Sat Oct 01 00:00:00 EDT 1983 · Arch. Intern. Med.; (United States)

DOI:https://doi.org/10.1001/archinte.143.10.1886· OSTI ID:6850342

Hlatky, M A; Lee, K L; Botvinick, E H; Brundage, B H

Health maintenance organizations (HMOs) have lower than average medical care costs, but the reasons remain controversial. The diagnostic practices of cardiologists from an HMO, a university, and a community were therefore surveyed. First, cardiologists defined indications for coronary bypass surgery and then evaluated randomly selected case summaries of patients with chest pain. After review, the cardiologist rated the need for an exercise thallium scintiscan and for a coronary angiogram in each case. Community cardiologists had the broadest indications for bypass surgery. The HMO cardiologists chose thallium scintigraphy significantly less often than the other two types of cardiologists did. The HMO and university cardiologists both rated the need for coronary angiography significantly lower than did community cardiologists. Physicians in different practice settings therefore recommend costly diagnostic and therapeutic methods differently, even for identical patients.

• OSTI ID: 6850342
• Journal Information: Arch. Intern. Med.; (United States), Journal Name: Arch. Intern. Med.; (United States) Vol. 143:10; ISSN AIMDA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPARATIVE EVALUATIONS
COST BENEFIT ANALYSIS
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
HEART
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOLOGY
SCINTISCANNING
SURGERY
THALLIUM ISOTOPES