In this study, researchers from the United States evaluated variation among physicians in test ordering when caring for children with gastroenteritis. They also explored the effect of hospital charge information on any variation.
The team assessed 10 pediatric emergency medicine faculty and 5 fellows.
|Physicians' mean test charges varied more than 2-fold.|
|Archives of Pediatric and Adolescent Medicine|
They reviewed test-ordering practices during 3 periods.
In addition, the team initiated telephone contact with patients' families 7 days after care.
The team included 3198 individual visits in the study.
The determined that physicians' mean test charges varied more than 2-fold during the study's control period. Based on this data physicians were assigned to either a "high" (n = 8) or "low" (n = 7) test user group.
The team found that the differences in mean charges between high and low test users during the control period persisted during the study's intervention period.
The variation in physicians' use of intravenous fluid use also persisted in the intervention period.
The team found that in the lowest-acuity patients, low test users exhibited greater price sensitivity.
Patients treated by low test users did not differ in improved condition or family satisfaction. These patients had more unscheduled follow-up, but were not admitted more frequently.
Dr Elizabeth Powell's team concluded, "Physicians varied in resource use when treating children with gastroenteritis".
"High and low test users were sensitive to price information".
"This intervention did not seem to compromise patient outcome".