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首页> 外文期刊>The American Journal of Cardiology >Determinants of Resource Utilization in a Tertiary Pediatric and Congenital Echocardiographic Laboratory
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Determinants of Resource Utilization in a Tertiary Pediatric and Congenital Echocardiographic Laboratory

机译：三级儿科和先天性超声心动图实验室中资源利用的决定因素

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We sought to determine the relation between technical charges for transthoracic echocardiograms (TTE) and total time for study completion (TT), identify factors associated with high TT, and create a scoring system to predict high TT studies. We analyzed a quality improvement database that prospectively tracked patient flow through TTEs in our laboratory for 3 consecutive months. The performing sonographer or fellow recorded TT and its components for every study. Patient and scan characteristics were abstracted from the clinical database and technical charges from the financial database. Factors independently associated with high TT (top quartile >= 85 minutes) were identified in 1,686 studies and validated in the remaining 847 studies. Median age was 7.8 years (0 to 77.9) and median TT was 65 minutes (14 to 370 minutes). Charges correlated poorly with TT (r = 0.2). Multivaiiate analysis identified several independent factors associated with high TT. The final model had an area under the curve of 0.78 in the development sample and 0.75 in the validation sample. On the basis of the final model, we developed a risk score for TT >= 85 minutes. The prevalence of high TT was 15% in low-score studies, 51% in medium-score studies, and 81% in high-score studies. In conclusion, this is the first study to demonstrate poor correlation between technical charges for pediatric/congenital echocardiography and TT, identify risk factors for high TT, and develop a high TT risk scoring system. These data may assist in resource allocation for pediatric/congenital echocardiograms and inform reimbursement systems. (C) 2015 Elsevier Inc. All rights reserved.
机译：我们试图确定经胸超声心动图（TTE）的技术费用与完成研究（TT）的总时间之间的关系，确定与高TT相关的因素，并建立一个评分系统来预测高TT研究。我们分析了一个质量改进数据库，该数据库连续3个月跟踪了我们实验室中通过TTE进行的患者流量。表现出色的超声医师或同伴会为每项研究记录TT及其成分。从临床数据库中提取患者和扫描特征，并从财务数据库中提取技术费用。在1686项研究中确定了与高TT独立相关的因素（最高四分位数> = 85分钟），并在其余847项研究中进行了验证。中位年龄为7.8岁（0至77.9），中位TT为65分钟（14至370分钟）。电荷与TT的相关性很差（r = 0.2）。多元分析确定了与高TT相关的几个独立因素。最终模型在开发样本中的曲线下面积为0.78，在验证样本中的曲线下面积为0.75。在最终模型的基础上，我们得出了TT> = 85分钟的风险评分。在低分研究中，高TT的患病率为15％，在中分研究中为51％，在高分研究中为81％。总而言之，这是第一项证明儿科/先天性超声心动图技术收费与TT之间的相关性不佳，确定高TT危险因素并开发高TT风险评分系统的研究。这些数据可能有助于分配儿科/先天性超声心动图资源，并告知报销系统。 （C）2015 Elsevier Inc.保留所有权利。

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