Economic impact of prescreening on gastroenterology outpatient clinic practice.

Abstract

BACKGROUND:

Outpatient clinic activity represents a major workload for clinicians. Unnecessary outpatient visits place a strain on service provision, resulting in unnecessary delays for more urgent cases.

GOALS:

We sought to determine both the impact and economic benefit of employing phone follow-up and physician assistant (PA) triage systems on attendances at a gastroenterology outpatient department.

STUDY:

We performed a retrospective chart review of all patients attending a gastroenterology outpatient clinic over a 2-week period. Patients were categorized into new or follow-up attendees and the follow-up patients were further subcategorized into 1 of 4 groups: (1) those attending to receive results of investigations requiring no further treatment (group A); (2) those attending to receive results of investigations requiring further treatment (group B); (3) those attending with a chronic gastrointestinal disease requiring no active change in management (group C); (4) those attending with a chronic gastrointestinal disease requiring active change in management (group D). It was assumed that patients in group A could be managed by phone follow-up in place of clinic attendance and patients in group C could be triaged to see a PA.

RESULTS:

Out of a total of 329 outpatient attendees, 40 (12%) required no active intervention (group A) and would have been suitable for phone follow-up. A further 58 (18%) had stable disease, requiring no change in management and hence, could have been triaged to see a PA. Implementation of phone follow-up and patient review by PA could reduce salary expenses of outpatient practice by 17%.

CONCLUSIONS:

Our findings support routine prescreening of outpatient attendees to enhance the efficiency of gastroenterology outpatient practice.

• Authors: Fergal Donnellan, Gavin C Harewood, Daniel Cagney, Fadzwani Basri, Stephen E Patchett, Frank E Murray
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 44 Issue 4 Pg. e76-9 (Apr 2010) ISSN: 1539-2031 [Electronic] United States
• PMID: 20305467 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Ambulatory Care Facilities (economics, organization & administration)
• Appointments and Schedules
• Delivery of Health Care (economics, methods)
• Female
• Gastroenterology
• Gastrointestinal Diseases (therapy)
• Humans
• Male
• Mass Screening (economics, methods)
• Middle Aged
• Outpatients (statistics & numerical data)
• Physician Assistants (economics, statistics & numerical data)
• Practice Patterns, Physicians' (economics)
• Telephone (statistics & numerical data)
• Young Adult