Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Savolainen links antisocial behavior in childhood to disadvantage and poverty in adulthood

Norton et al. put dollar value on relief from chronic pain for Americans age 50+

Seefeldt says TANF restrictions may limit program's help for poor Americans

More News

Highlights

Paula Fomby to succeed Jennifer Barber as Associate Director of PSC

PSC community celebrates Violet Elder's retirement from PSC

Neal Krause wins GSA's Robert Kleemeier Award

U-M awarded $58 million to develop ideas for preventing and treating health problems

More Highlights

Tests and Expenditures in the Initial Evaluation of Peripheral Neuropathy

Archived Abstract of Former PSC Researcher

Callaghan, B., R. McCammon, K. Kerber, Xiao Xu, Kenneth M. Langa, and E. Feldman. 2012. "Tests and Expenditures in the Initial Evaluation of Peripheral Neuropathy." Archives of Internal Medicine, 172(2): 127-132.

Background: Peripheral neuropathy is a common disorder in which an extensive evaluation is often unrevealing. Methods: We sought to define diagnostic practice patterns as an early step in identifying opportunities to improve efficiency of care. The 1996-2007 Health and Retirement Study Medicare claims-linked database was used to identify individuals with an incident diagnosis of peripheral neuropathy using International Classification of Diseases, Ninth Revision, codes and required no previous neuropathy diagnosis during the preceding 30 months. Focusing on 15 relevant tests, we examined the number and patterns of tests and specific test utilization 6 months before and after the incident neuropathy diagnosis. Medicare expenditures were assessed during the baseline, diagnostic, and follow-up periods. Results: Of the 12 673 patients, 1031 (8.1%) received a new International Classification of Diseases, Ninth Revision, diagnosis of neuropathy and met the study inclusion criteria. Of the 15 tests considered, a median of 4 (interquartile range, 2-5) tests were performed, with more than 400 patterns of testing. Magnetic resonance imaging of the brain or spine was ordered in 23.2% of patients, whereas a glucose tolerance test was rarely obtained (1.0%). Mean Medicare expenditures were significantly higher in the diagnostic period than in the baseline period ($14 362 vs $8067, P<.001). Conclusions: Patients diagnosed as having peripheral neuropathy typically undergo many tests, but testing patterns are highly variable. Almost one-quarter of patients receiving neuropathy diagnoses undergo high-cost, low-yield magnetic resonance imaging, whereas few receive low-cost, high-yield glucose tolerance tests. Expenditures increase substantially in the diagnostic period. More research is needed to define effective and efficient strategies for the diagnostic evaluation of peripheral neuropathy.

Country of focus: United States of America.

Browse | Search : All Pubs | Next