当前位置： SCI文献检索 > INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS期刊下所有文献 > The introduction of a diagnostic decision support system (DXplain™) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).

The introduction of a diagnostic decision support system (DXplain™) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).

Abstract：

BACKGROUND:In an era of short inpatient stays, residents may overlook relevant elements of the differential diagnosis as they try to evaluate and treat patients. However, if a resident's first principal diagnosis is wrong, the patient's appropriate evaluation and treatment may take longer, cost more, and lead to worse outcomes. A diagnostic decision support system may lead to the generation of a broader differential diagnosis that more often includes the correct diagnosis, permitting a shorter, more effective, and less costly hospital stay. METHODS:We provided residents on General Medicine services access to DXplain, an established computer-based diagnostic decision support system, for 6 months. We compared charges and cost of service for diagnostically challenging cases seen during the fourth through sixth month of access to DXplain (intervention period) to control cases seen in the 6 months before the system was made available. RESULTS:564 cases were identified as diagnostically challenging by our criteria during the intervention period along with 1173 cases during the control period. Total charges were $1281 lower (p=.006), Medicare Part A charges $1032 lower (p=0.006) and cost of service $990 lower (p=0.001) per admission in the intervention cases than in control cases. CONCLUSIONS:Using DXplain on all diagnostically challenging cases might save our medical center over $2,000,000 a year on the General Medicine Services alone. Using clinical diagnostic decision support systems may improve quality and decrease cost substantially at teaching hospitals.

journal_name

Int J Med Inform

journal_title

International journal of medical informatics

authors

Elkin PL,Liebow M,Bauer BA,Chaliki S,Wahner-Roedler D,Bundrick J,Lee M,Brown SH,Froehling D,Bailey K,Famiglietti K,Kim R,Hoffer E,Feldman M,Barnett GO

doi

10.1016/j.ijmedinf.2010.09.004

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

772-7

issue

eissn

1386-5056

issn

1872-8243

pii

S1386-5056(10)00162-0

journal_volume

pub_type

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The introduction of a diagnostic decision support system (DXplain™) into the workflow of a teaching hospital service can decrease the cost of service for diagnostically challenging Diagnostic Related Groups (DRGs).