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The British Journal of Radiology Nov 2006Demand for radiology services within the National Health Service (NHS) continues unabated and current NHS operations cannot keep up with demand. Therefore, to meet this...
Demand for radiology services within the National Health Service (NHS) continues unabated and current NHS operations cannot keep up with demand. Therefore, to meet this demand, the government has decided to outsource a significant number of investigations to the independent sector and will actively promote patient referrals to the new government sponsored Treatment Centres as they become available. This presents opportunities to patients, but threatens existing public sector providers (including doctors) as competition for radiology services may result in both loss of patient referrals and revenue to these providers. This article is a personal opinion and will focus on the current challenges facing the provision of radiology services in the NHS. I will suggest the possible negative outcomes for providers (NHS hospitals and staff alike) and will offer strategies, tactics and tools that can be employed to counter the threat to their existing services.
Topics: Diagnostic Services; Health Care Reform; Humans; National Health Programs; Radiology
PubMed: 16945933
DOI: 10.1259/bjr/80900968 -
Dermatology (Basel, Switzerland) 2013To evaluate organizational structure and diagnostic procedures used by the Italian hospital network for identifying cutaneous melanoma.
OBJECTIVE
To evaluate organizational structure and diagnostic procedures used by the Italian hospital network for identifying cutaneous melanoma.
METHODS
A nationwide survey of a representative sample of centers was conducted.
RESULTS
Diagnosis occurs mainly in ambulatory dermatology clinics (91%). In all high-volume hospitals, clinical and dermoscopic examination is available at first consultation or as an additional service, compared to 89% of low-volume hospitals. Computer-assisted videodermoscopy is available in 75% of hospitals, with a statistically significant difference between high- and low-volume hospitals (86 vs. 62%; p < 0.001). First consultation is generally an integrated clinical/dermoscopic evaluation (55% of high-volume centers vs. 47% of low-volume hospitals); digital evaluation is available for monitoring suspicious lesions and high-risk patients in 25% of high-volume centers versus 19% of low-volume centers.
CONCLUSIONS
The organizational structure and diagnostic procedures in Italian hospitals are in line with modern diagnostic procedures for early diagnosis of melanoma. Dermatologists have a central role in managing diagnosis of primitive melanoma.
Topics: Dermatology; Dermoscopy; Diagnostic Services; Humans; Italy; Melanoma; Skin Neoplasms; Statistics as Topic
PubMed: 23736263
DOI: 10.1159/000348860 -
Annals of Emergency Medicine May 2006
Topics: Diagnostic Services; Emergency Service, Hospital; Health Services Accessibility; Hospital Administration; Humans; United States
PubMed: 16631999
DOI: 10.1016/j.annemergmed.2006.01.030 -
Clinical Chemistry and Laboratory... 2005
Topics: Clinical Laboratory Techniques; Diagnostic Services; Forecasting; Humans
PubMed: 16176165
DOI: 10.1515/CCLM.2005.152 -
Journal of Hospital Medicine Jan 2010The pediatric hospitalist program at the Children's Hospital of Pittsburgh (CHP)-the Diagnostic Referral Service (DRS)-was first described in the pediatric literature in...
The pediatric hospitalist program at the Children's Hospital of Pittsburgh (CHP)-the Diagnostic Referral Service (DRS)-was first described in the pediatric literature in 1988. At that time, the group consisted of 5 members with a variety of inpatient and outpatient responsibilities. Since then, there has been a significant nationwide growth in pediatric hospital medicine. In the same time frame, the DRS has also grown significantly, with new and enhanced responsibilities in both the inpatient and outpatient settings. This work reflects on the recent trends in pediatrics that resulted in the growth of specialists in hospital medicine and in the evolution of the DRS responsibilities. A detailed description of the unique changes in the DRS is provided as a model for effective care of children in the modern era.
Topics: Diagnostic Services; History, 20th Century; History, 21st Century; Hospitals, Pediatric; Humans; Interdisciplinary Communication; Pennsylvania; Referral and Consultation
PubMed: 20063284
DOI: 10.1002/jhm.553 -
The Southeast Asian Journal of Tropical... Jun 2003This cross-sectional experimental study developed a methodology to analyze the cost-effectiveness of three malaria diagnostic models: microscopy; on-site OptiMAL; and... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
This cross-sectional experimental study developed a methodology to analyze the cost-effectiveness of three malaria diagnostic models: microscopy; on-site OptiMAL; and on-site Immunochromatographic Test (on-site ICT), used in remote non-microscope areas in Thailand, from both a public provider and patient perspective. The study covered six areas in two highly malaria-endemic areas of provinces located along the Thai-Myanmar border. The study was conducted between April and October 2000, by purposively recruiting 436 malaria suspected cases attending mobile malaria clinics. Each patient was randomly selected to receive service via the three diagnostic models; their accuracy was 95.17%, 94.48% and 89.04%, respectively. In addition, their true positive rates for all malaria species were 76.19%, 82.61% and 73.83%; for falciparum malaria 85.71%, 80.95% and 80.00%, and for vivax malaria 57.14%, 100% and 50%, respectively, with the parasitemia ranging from 80 to 58,240 microl of blood. Consequently, their costs were determined by dividing into provider and consumer costs, which were consequently classified into internal and external costs. The internal costs were the costs of the public providers, whereas the external costs were those incurred by the patients. The aggregate costs of these three models were 58,500.35, 36,685.91, and 40,714.01 Baht, respectively, or 339.53, 234.39, and 243.93, in terms of unit costs per actual case. In the case of microscopy, if all suspected malaria cases incurred forgone opportunity costs of waiting for treatment, the aggregate cost and unit cost per actual case were up to 188,110.89 and 944.03 Baht, respectively. Accordingly, the cost-effectiveness for all malaria species, using their true positive rates as the effectiveness indicator, was 446.75, 282.40, and 343.56 respectively, whereas for falciparum malaria it was 394.80, 289.37 and 304.91, and for vivax malaria 595.67, 234.39 and 487.86, respectively. This study revealed that the on-site OptiMAL was the most cost-effective. It could be used to supplement or even replace microscopy for this criteria in general. This study would be of benefit to malaria control program policy makers to consider using RDT technology to supplement microscopy in remote non-microscope areas.
Topics: Chromatography; Cost-Benefit Analysis; Cross-Sectional Studies; Diagnostic Services; Humans; Immunoassay; Malaria; Microscopy; Myanmar; Reagent Kits, Diagnostic; Sensitivity and Specificity; Specimen Handling; Thailand
PubMed: 12971557
DOI: No ID Found -
Gastrointestinal Endoscopy Apr 1987
Topics: Diagnostic Services; Endoscopes; Gastroenterology; Greece; Humans
PubMed: 3569800
DOI: 10.1016/s0016-5107(87)71543-0 -
The Journal of the Florida Medical... Oct 1991
Topics: Diagnostic Services; Humans; Malpractice; Practice Patterns, Physicians'
PubMed: 1753235
DOI: No ID Found -
British Medical Journal Nov 1980
Topics: Decision Making; Diagnostic Services; Humans; United Kingdom; United States
PubMed: 7427675
DOI: 10.1136/bmj.281.6250.1285-a -
Health Economics 1994The paper investigates the benefit the patient derives from medical diagnosis. By considering explicitly the prospects with respect to both health and monetary...
The paper investigates the benefit the patient derives from medical diagnosis. By considering explicitly the prospects with respect to both health and monetary consequences resulting from a decision taken by the physician, a fairly general approach to discuss diagnostic services is developed. The willingness to pay of the patient is taken to be measured by his compensating option price, evaluated with respect to the reference state without further diagnostic information. Of particular interest are conditions governing positivity of the patient benefit. Imposing additional restrictions upon individual preferences considerably simplifies the analysis by relying on a loss function. The final section discusses the role of the patient benefit as regards cost-benefit analysis of diagnostic services. If health insurance is available providing at least partial coverage, a positive willingness to pay of the patient net of diagnostic cost can be shown to give no clue as to whether utilization of a diagnostic service is beneficial to society in the sense of cost-benefit analysis.
Topics: Attitude to Health; Consumer Behavior; Cost-Benefit Analysis; Decision Making; Diagnostic Services; Financing, Personal; Health Services Research; Humans; Insurance Benefits; Models, Economic; Probability; Treatment Outcome
PubMed: 7994325
DOI: 10.1002/hec.4730030407