Diagnostic Test Ordering in the Evaluation of Febrile Children

McGillivray, David; Roberts-Bräuer, Renée; Kramer, Michael S.

doi:10.1001/archpedi.1993.02160320072022

Cited by 28 publications

(15 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several studies have found lower rates of diagnostic testing among more experienced physicians. (14, 22) For example, less-experienced physicians are more likely to order unnecessary imaging when seeing a patient with back pain. (22) On the other hand, other research has found the opposite relationship.…”

Section: Discussionmentioning

confidence: 99%

“…Prior work has been limited to examinations of the association between physician characteristics and use of specific services such as laboratory testsor the clinical decisions made in hypothetical clinical scenarios. (3-14) Here, in a large sample of Massachusetts physicians, we examined the relationship between publicly available physician characteristics and performance on cost profiles.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Physicians With The Least Experience Have Higher Cost Profiles Than Do Physicians With The Most Experience

et al. 2012

View full text Add to dashboard Cite

Health plans and Medicare are using cost profiles to identify high-cost physicians in the hope of lowering total health care spending, but it is unclear which types of physicians will be most affected. Using cost profiles created from health plan claims, we examined which physician characteristics are associated with higher costs. Our strongest association was related to a physician’s year of experience. Compared to the most experienced physicians, the least experienced physicians had 13 percent higher overall costs. We found no association between costs and other factors such as malpractice claims, disciplinary action, board certification status, and the size of the group in which the physician practices. While winners and losers are inevitable in any cost profiling effort, physicians with less experience are more likely to be negatively affected by policies that utilize cost profiles. For example, they could be excluded from high-value networks or receive lower payments under Medicare’s planned value-based payment program. Further, our results raise the possibility that the more costly practice style of newly trained physicians may be a driver of rising health care costs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physicians With The Least Experience Have Higher Cost Profiles Than Do Physicians With The Most Experience

et al. 2012

View full text Add to dashboard Cite

show abstract

“…26,27 Our study identifi ed an example of laboratory overuse that lends itself to efforts for quality improvement, such as using audits to change existing behaviors. 28 Administrative solutions have also been used successfully in decreasing laboratory overutilization.…”

Section: Discussionmentioning

confidence: 99%

Serum Magnesium Levels in Pediatric Inpatients: A Study in Laboratory Overuse

Narayanan

Scalici

2015

Hospital Pediatrics

View full text Add to dashboard Cite

show abstract

“…4,5 Previous articles have strongly supported these findings. 1Y3,11,12 Most investigations of clinical performance of physicians have focused on the management of a single disease, 4,6,8,13 whereas we analyzed clinical performance based on multiple variable diseases in the pediatric ED.…”

Section: Clinical Practice By Pediatric Attending Physicians Reduces mentioning

confidence: 99%

“…8 According to McGillivray et al, 6 attending physicians with more than 10 years of Tables 2 and 3 except Bothers,[ which included specific disease caused by Coxsackie virus, other general symptoms, urinary tract infection, and gastritis and duodenitis with ICD-9-CM codes 074, 780.9, 599.0, 535, and those less than 1% of all cases, respectively. clinical experience order fewer tests than physicians in training do when diagnosing pediatric febrile emergencies.…”

Section: The Clinical Implications From the Analysis Of 3 Major Commomentioning

confidence: 99%

Comparative Clinical Practice of Residents and Attending Physicians Who Care for Pediatric Patients in the Emergency Department

Chang

Tzeng

et al. 2008

Pediatric Emergency Care

View full text Add to dashboard Cite

show abstract

Diagnostic Test Ordering in the Evaluation of Febrile Children

Cited by 28 publications

References 8 publications

Physicians With The Least Experience Have Higher Cost Profiles Than Do Physicians With The Most Experience

Physicians With The Least Experience Have Higher Cost Profiles Than Do Physicians With The Most Experience

Serum Magnesium Levels in Pediatric Inpatients: A Study in Laboratory Overuse

Comparative Clinical Practice of Residents and Attending Physicians Who Care for Pediatric Patients in the Emergency Department

Contact Info

Product

Resources

About