title: Esophagogastroduodenoscopy by a family physician: a case series demonstrating health care savings.
abstract: Rural Army community hospitals without gastroenterologists require civilian referrals for esophagogastroduodenoscopies (EGDs). The goal was to determine whether an endoscopy-trained, military family physician saved health care dollars at an Army community hospital by decreasing outside referrals. We present a chart review of all 95 EGDs performed by a family physician at an Army community hospital between September 2003 and May 2005. The total facility cost was determined by using the cost of personnel, lost clinic hours, equipment, supplies, medications, continuing medical education, missed diagnoses, procedure complications, and need for additional referrals. The potential referral cost was determined by using local civilian endoscopy billing codes and TRICARE reimbursement rates for 2004. The total facility cost was $22,655.65 ($238.48 per EGD). The total referral cost would have been $55,614.95 ($585.42 per EGD). Using a family physician saved the hospital $32,959.30 ($346.94 per EGD). An endoscopy-trained family physician saved significant health care dollars at an Army community hospital.
authors.affiliation: Department of Family Medicine, Madigan Army Medical Center, Tacoma, WA 98431-1100, USA.
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Runser
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Short
mesh_terms: D003695:Delivery of Health Care; D016145:Endoscopy, Digestive System; D006772:Hospitals, Military; D006801:Humans; D008889:Military Personnel; D010821:Physicians, Family