Cost assessment of the evaluation of heart murmurs in children

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Echocardiography available directly to primary care physicians represents an alternative strategy to pediatric cardiology consultation for childhood heart murmur evaluation. A decision analysis model compared the costs of two diagnostic strategies: (1) echocardiography first, referral to the cardiologist if appropriate; and (2) cardiologist evaluates murmur, echocardiography if appropriate. The model incorporated probability of heart disease, frequency of cardiologist-ordered echocardiography, and echocardiography results established by review of 388 records of consecutive patients evaluated for murmurs in a pediatric cardiology clinic. Echocardiography-first strategy costs were $257 greater than referral-strategy costs. Referral-strategy advantages were not highly sensitive to changes in model assumptions. Pediatric cardiology consultation is the preferred approach provided (1) consultation costs are moderate, (2) echocardiography costs are moderate to high, and (3) the rate at which the cardiologist orders echocardiography for patients with innocent murmurs is low.

Original languageEnglish (US)
Pages (from-to)365-368
Number of pages4
JournalPediatrics
Volume91
Issue number2
StatePublished - Jan 1 1993

Fingerprint

Heart Murmurs
Echocardiography
Costs and Cost Analysis
Referral and Consultation
Cardiology
Pediatrics
Decision Support Techniques
Primary Care Physicians
Heart Diseases
Cardiologists

Keywords

  • congenital heart disease
  • cost assessment
  • echocardiography
  • heart murmur

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Cost assessment of the evaluation of heart murmurs in children. / Danford, David Alan; Nasir, Arwa K; Gumbiner, Carl Herbert.

In: Pediatrics, Vol. 91, No. 2, 01.01.1993, p. 365-368.

Research output: Contribution to journalArticle

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