检索结果-南通市图书馆

Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system

引用

World Journal of Clinical Cases 2018年第13期6卷 624-631页

作者： Andrew Khoi Nguyen Agathon Girgis Timnit Tekeste Karen Chang Mopelola Adeyemo Armen Eskandari Emilio Alonso Priyanka Yaramada Charles Chaya Albert Ko Edmund Burke Isaiah Roggow Rebecca Butler Aniket Kawatkar Brian S Lim School of Medicine University of California Department of Gastroenterology Kaiser Permanente Riverside Medical Center Department of Surgery Kaiser Permanente Riverside Medical Center Department of Research and Evaluation Southern California Permanente Medical Group

AIM To examine the practice pattern in Kaiser Permanente Southern California(KPSC), i.e., gastroenterology(GI)/surgery referrals and endoscopic ultrasound(EUS), for pancreatic cystic neoplasms(PCNs) after the regionwide dissemination of the PCN management algorithm.METHODS Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015(18 mo before and after the publication of the algorithm) in KPSC(integrated health system with 15 hospitals and 202 medical offices in Southern California) were identified.RESULTS2558(1157 pre-and 1401 post-algorithm) received a new diagnosis of PCN in the study period. There was no difference in the mean cyst size(pre-19.1 mm vs post-18.5 mm, P = 0.119). A smaller percentage of PCNs resulted in EUS after the implementation of the algorithm(pre-45.5% vs post-34.8%, P < 0.001). A smaller proportion of patients were referred for GI(pre-65.2% vs post-53.3%, P < 0.001) and surgery consultations(pre-24.8% vs post-16%, P < 0.001) for PCN after the implementation. There was no significant change in operations for PCNs. Cost of diagnostic care was reduced after the implementation by 24%, 18%, and 36% for EUS, GI, and surgery consultations, respectively, with total cost saving of 24%.CONCLUSION In the current healthcare climate, there is increased need to optimize resource utilization. Dissemination of an algorithm for PCN management in an integrated health system resulted in fewer EUS and GI/surgery referrals, likely by aiding the physicians ordering imaging studies in the decision making for the management of PCNs. This translated to cost saving of 24%, 18%, and 36% for EUS, GI, and surgical consultations, respectively, with total diagnostic cost saving of 24%.

关键词： Pancreatic cyst Algorithm incorporation Pancreas Optimization of resource utilization fukuoka criteria Sendai criteria Pancreatic cancer Intraductal papillary mucinous neoplasm Practice management Algorithm

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：