University of Twente Student Theses


Budget Impact Analysis of Abdominal Ultrasound in Dutch Primary Care

Adema, N. (2018) Budget Impact Analysis of Abdominal Ultrasound in Dutch Primary Care.

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Abstract:Background: The transition of diagnostic ultrasound to general practice serves as alternative to traditional hospital-based ultrasound examinations. This study’s objective was to investigate this transition, by evaluating the impact of abdominal ultrasound on hospital referrals and healthcare costs in general practice, hospital care and diagnostic treatment centres (DTCs). Methods: A budget impact analysis was conducted using reimbursement data from a health insurer’s perspective. Ultrasound reimbursement claims and diagnosis treatment combinations were compared between general practices, hospitals and DTCs for approximately 52,000 patients. In addition, eleven semi-structured interviews were performed to identify the opinions and experiences of general practitioners (GPs) and radiologists towards ultrasound examinations in general practice. Results: Considering a 6- and 12-week time horizon, lower referral rates were found for patients receiving ultrasound in general practice (15% and 19%) relative to patients receiving ultrasound in hospital care (20% and 25%) and DTCs (18% and 22%). In addition, average ultrasound costs per patient as well as average treatment costs per patient < 12 weeks were lowest for patients from general practice. Important preconditions mentioned by GPs and radiologists for performing ultrasound examinations in general practice entail archiving and reporting of images in an electronic health record, the availability of a patient’s medical history data and intensive collaboration between a GP and radiologist. Conclusions: Abdominal ultrasound in general practice leads to lower costs compared to abdominal ultrasounds performed in hospitals and DTCs, caused by the use of different reimbursement tariffs for ultrasound examinations and fewer referrals to specialist care. As this study only focussed on the financial impact of abdominal ultrasound in primary care, further studies are needed to investigate the impact of diagnostic ultrasound from a broader perspective such as its effects on health outcomes. Keywords: Abdominal ultrasound, budget impact analysis, general practice, patient management, primary care
Item Type:Essay (Master)
Menzis, Wageningen, The Netherlands
Faculty:TNW: Science and Technology
Subject:01 general works
Programme:Health Sciences MSc (66851)
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