Search

Your search keyword '"Hillman, Bruce J."' showing total 1,251 results
Start Over Author "Hillman, Bruce J."
1,251 results on '"Hillman, Bruce J."'

30. Physicians' utilization and charges for outpatient diagnostic imaging in a Medicare population

Author

Hillman, Bruce J., Olson, George T., Griffith, Patricia E., Sunshine, Jonathan H., Joseph, Catherine A., Kennedy, Stephen D., Nelson, William R., and Bernhardt, Lee B.

Subjects
Diagnostic imaging -- Economic aspects, Medical referral -- Economic aspects
Abstract

Patients may undergo more diagnostic imaging tests at a greater cost if their physicians do the tests in their office (self-referral) rather than referring the patient to a radiologist. A study of 174,800 claims submitted to the United Mine Workers of America Health and Retirement Funds within a two-year period found that doctors who did the procedures themselves were much more likely to order the test. The average cost of each test performed in the doctor's office was 1.6 to 6.2 times the cost of the test performed by a radiologist. There has been much in the media about physicians who refer patients to clinics in which the physician has a financial interest. These physicians may order more tests, but there is no evidence that the greater use of diagnostic tests has improved the health of their patients. To reduce health care costs, third-party payers may reimburse self-referring doctors at a lower rate.

Published
1992

31. Frequency and costs of diagnostic imaging in office practice - a comparison of self-referring and radiologist-referring physicians

Author

Hillman, Bruce J., Joseph, Catherine A., Mabry, Michael R., Sunshine, Jonathan H., Kennedy, Stephen D., and Noether, Monica

Subjects
Medical referral -- Evaluation, Diagnostic imaging -- Evaluation, Diagnostic imaging -- Finance, Physician services utilization -- Economic aspects
Abstract

To determine whether physicians who perform imaging studies (ultrasonography or X-ray) in their own offices order such tests more often than physicians who routinely refer patients to radiologists for the same types of studies, an evaluation was performed of 60,829 outpatient cases treated by 6,419 physicians. Four diagnoses were of interest: acute upper respiratory infections (chest X-ray); pregnancy (ultrasonography); low back pain (spinal X-ray); and difficulty in urination (in men; various X-ray or ultrasound studies). The physicians who filed the claims were classified as self-referring or as radiologist-referring. Upper respiratory infections made up the majority of episodes (47,794), with normal pregnancy (1,377), back pain (9,634) and men with difficult urination (2,024) following in order of frequency. Self-referring physicians charged more for imaging than those who referred to radiologists for all diagnoses except difficult urination. When an episode involved a self-referring physician, it was between 4 and 4.5 times more likely to lead to imaging than when it involved a radiologist-referring physician. Comparisons among medical specialties revealed that the extent of increased use of imaging by self-referring physicians versus radiologist-referring physicians varied widely (from 2.4 to 11.1 times as often), depending on the specialty. The results were not influenced by differences in patient type or the complexity of studies performed. While the appropriateness of the care provided by any of the physicians cannot be evaluated, the results are certain to be interesting to regulatory and reimbursement agencies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

Catalog

Books, media, physical & digital resources
See catalog results