IMPACT OF PROSPECTIVE PEER-REVIEW ON PACEMAKER IMPLANTATION RATES IN MASSACHUSETTS

被引:9
作者
FALK, RH [1 ]
机构
[1] BOSTON UNIV,SCH MED,BOSTON,MA 02118
关键词
D O I
10.1016/0735-1097(90)90245-K
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Preapproval of elective permanent pacemaker insertions in Medicare patients is now mandatory for reimbursement. Of 1,860 requests for approval of an initial pacemaker implant in Massachusetts, 1,494 (80.3%) met strict Medicare guidelines and were approved by a nurse reviewer, and 366 (19.7%) were referred to an independent physician because of a question of appropriateness of indication or type of pacemaker. Only five requests (0.27%) were denied because of an inappropriate indication for pacing. On a second review of these records, an additional eight pacemaker insertions (0.43%) were deemed to have been inappropriately approved. Comparison of the annualized number of pacemaker requests for the study period with those of the 3 years before mandatory approval revealed a reduction of only 3.7%. Thus, contrary to previous findings in other areas of the country, in Massachusetts, inappropriate pacemaker insertions are rare and the effect of the prior approval process is minimal. © 1990.
引用
收藏
页码:1087 / 1092
页数:6
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