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The diagnostic yield of pediatric polysomnography based on the professional background of referring physicians

机译：基于转诊医师专业背景的小儿多导睡眠图诊断率

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Introduction. Polysomnography (PSG) is the gold standard in diagnosis of sleep-disordered breathing but is labor intensive and expensive. We assessed PSG outcomes based on physician specialty and whether prior referral to sleep clinics reduces costs for children with sleep problems. Methods. Retrospective analysis of PSGs was performed by demographics, physician specialization, PSG indication, and results. Average costs of evaluating PSGs ordered by primary care physicians (PCPs) versus initial referral to sleep specialists were compared. Results. A total of 493 PSGs were performed between June 2010 and December 2010. Most referrals came from sleep physicians (31%), otolaryngologists (24%), and PCPs (18%). Forty-four percent PSGs ordered by PCPs were normal versus 22% by sleep physicians (odds ratio = 2.8, P <.05). Average cost of PSGs ordered by PCPs was $3053.54/patient versus $917.85/patient for sleep specialist referral. Conclusion. PSGs ordered by PCPs were more likely to be normal than PSGs by sleep physicians. Sleep clinic assessment before PSGs may assist in appropriate service utilization, improve delivery of care, and reduce health care costs by using these tests appropriately.
机译：介绍。多导睡眠图（PSG）是诊断睡眠呼吸障碍的金标准，但劳动强度大且价格昂贵。我们根据医生的专长以及是否事先转诊到睡眠诊所来减少患有睡眠问题的儿童的费用，来评估PSG的结局。方法。 PSG的回顾性分析通过人口统计学，医师专业知识，PSG适应症和结果进行。比较了由初级保健医师（PCP）订购的PSG与初始转诊给睡眠专家的评估平均费用。结果。在2010年6月至2010年12月之间，总共进行了493次PSG检查。大多数转诊来自睡眠医生（31％），耳鼻喉科医生（24％）和PCP（18％）。 PCP订购的PSG占44％是正常的，而睡眠医生则为22％（几率= 2.8，P <.05）。 PCP订购的PSG的平均费用为每位患者$ 3053.54，而转诊给睡眠专家的每位患者为$ 917.85。结论。与睡眠医生的PSG相比，PCP所订购的PSG更有可能是正常的。通过适当使用这些测试，在PSG之前进行睡眠诊所评估可能有助于适当地利用服务，改善护理质量并降低医疗保健成本。

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