Choosing Wisely: highest-cost tests in outpatient neurology

Ann Neurol. 2013 May;73(5):679-83. doi: 10.1002/ana.23865. Epub 2013 Apr 17.

Abstract

Identifying the tests/procedures ordered by neurologists that contribute most to health care expenditures is a critical step in the process of creating the neurology top 5 list for the Choosing Wisely initiative. Using data from the 2007-2010 National Ambulatory Care Medical Survey, we found that $13.3 billion (95% confidence interval = $10.1-$16.5 billion) was spent on tests ordered at neurologist visits. The tests/procedures with the highest expenditures were magnetic resonance imaging (MRI; 51% of total expenditures; $7.5 billion), electromyography (EMG; 20% of expenditures; $2.6 billion), and electroencephalography (EEG; 8% of expenditures; $1.1 billion). MRI, EMG, and EEG should receive close scrutiny in the development of the neurology top 5 list.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Electroencephalography
  • Electromyography
  • Health Care Costs / statistics & numerical data*
  • Health Expenditures / statistics & numerical data
  • Humans
  • Magnetic Resonance Imaging
  • Nervous System Diseases / diagnosis*
  • Nervous System Diseases / economics*
  • Nervous System Diseases / epidemiology
  • Neurology*
  • Outpatients