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Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians.

Publication ,  Journal Article
Kozak, PM; Trumbo, SP; Christensen, BW; Leverenz, DL; Shotwell, MS; Kingeter, AJ
Published in: Int J Cardiovasc Imaging
July 2019

Previous studies have demonstrated the impact of appropriate use criteria (AUC) education and feedback interventions in reducing unnecessary ordering of transthoracic echocardiography (TTE) by trainees. To our knowledge, no study has evaluated the impact of the addition of price transparency to this education and feedback model on TTE utilization by resident physicians. We performed an education and feedback quality improvement initiative combining charge transparency data with information on AUC. We hypothesized that the initiative would reduce the number of complete TTE ordered and increase the number of limited TTE ordered, anticipating there would be substitution of limited for complete studies. Residents rotating on inpatient teaching cardiology ward teams received education on AUC for TTE, indications for limited TTE, and hospital charges for TTE. Feedback was provided on the quantity and charges for complete and limited TTE ordered by each team. We analyzed the effects of the intervention using a linear mixed effects regression model to adjust for potential confounders. The post-intervention weeks showed a reduction of 4.6 complete TTE orders per 100 patients from previous weekly baseline of 31.3 complete TTE orders per 100 patients (p value = 0.012). Charges for complete TTE decreased $122 from baseline of $980 per patient (p value = 0.040) on a per-week basis. Secondarily, there was no statistically significant change in limited TTE ordering during the intervention period. This initiative shows the feasibility of a house staff-driven charge transparency and education/feedback initiative that decreased medical residents' ordering of inpatient TTE.

Duke Scholars

Published In

Int J Cardiovasc Imaging

DOI

EISSN

1875-8312

Publication Date

July 2019

Volume

35

Issue

7

Start / End Page

1259 / 1263

Location

United States

Related Subject Headings

  • Unnecessary Procedures
  • Quality Indicators, Health Care
  • Quality Improvement
  • Prospective Studies
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Nuclear Medicine & Medical Imaging
  • Internship and Residency
  • Inpatients
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kozak, P. M., Trumbo, S. P., Christensen, B. W., Leverenz, D. L., Shotwell, M. S., & Kingeter, A. J. (2019). Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians. Int J Cardiovasc Imaging, 35(7), 1259–1263. https://doi.org/10.1007/s10554-019-01572-2
Kozak, Patrick M., Silas P. Trumbo, Bradley W. Christensen, David L. Leverenz, Matthew S. Shotwell, and Adam J. Kingeter. “Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians.Int J Cardiovasc Imaging 35, no. 7 (July 2019): 1259–63. https://doi.org/10.1007/s10554-019-01572-2.
Kozak PM, Trumbo SP, Christensen BW, Leverenz DL, Shotwell MS, Kingeter AJ. Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians. Int J Cardiovasc Imaging. 2019 Jul;35(7):1259–63.
Kozak, Patrick M., et al. “Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians.Int J Cardiovasc Imaging, vol. 35, no. 7, July 2019, pp. 1259–63. Pubmed, doi:10.1007/s10554-019-01572-2.
Kozak PM, Trumbo SP, Christensen BW, Leverenz DL, Shotwell MS, Kingeter AJ. Addition of price transparency to an education and feedback intervention reduces utilization of inpatient echocardiography by resident physicians. Int J Cardiovasc Imaging. 2019 Jul;35(7):1259–1263.

Published In

Int J Cardiovasc Imaging

DOI

EISSN

1875-8312

Publication Date

July 2019

Volume

35

Issue

7

Start / End Page

1259 / 1263

Location

United States

Related Subject Headings

  • Unnecessary Procedures
  • Quality Indicators, Health Care
  • Quality Improvement
  • Prospective Studies
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Nuclear Medicine & Medical Imaging
  • Internship and Residency
  • Inpatients
  • Humans