[Diagnostic procedure for uveitis patients: reduction of costs by a targeted assessment of laboratory tests based on clinical findings].
BACKGROUND
Interdisciplinarity is an essential prerequisite for extensive and high-quality diagnostic work-up, therapy, and care of patients with inflammatory rheumatic disease. The ophthalmological status significantly narrows down the possible causes for the primary disease and facilitates an effective diagnostic approach.


METHODS
We developed an assessment procedure according to the individual clinical findings to use as an ideal diagnostic strategy for an interdisciplinary center. To permit comparability we first introduced this new diagnostic tool in November 2002 (intervention), replacing the existing cost-intensive standard diagnostic procedure for uveitis patients.


RESULTS
The average costs for laboratory tests (calculated according to GOA numbers, scale of fees for physicians) were reduced from 670+/-11 euros per patient before the intervention to 238+/-18 euros per patient after the intervention. Before intervention 16 of 31 (52%) could be assigned to a specified disease compared to 27 of 53 (51%) after the intervention. With our strategy we were able to obtain a 64% reduction of costs in the diagnostics of uveitis patients without a deterioration of our diagnostic quality.


CONCLUSIONS
It is possible to reduce costs and still improve the care of uveitis patients by using a targeted assessment according to the individual clinical findings.
Interdisziplinäres Uveitiszentrum und Augenklinik, Universität Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg. Annette_Rupp@med.uni-heidelberg.de
A
A
Lösch
S
S
Flessa
C
C
Fiehn
R
R
Max
M D
MD
Becker
D019411:Clinical Laboratory Techniques / Q000191:economics* / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D014605:Uveitis / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000628:therapy