Evaluation of Neurologist Care Delivery: A Single Academic Center Exploratory Study
Andrew George1, Ra'ed Hailat2, Ankit Annapareddy1, Benjamin Templeton1, Nicholas Capaci2, Terese Gullo2, James Burke2, Kevin Kerber2
1College of Medicine, The Ohio State University, 2Department of Neurology, Ohio State University Wexner Medical Center
Objective:
To characterize
services rendered by neurologists at clinical evaluations to inform the value of neurologic care.
Background:
Characterizing elements of neurologic care and thus the overall value of neurologic care is challenging due to measurement limitations. Administrative data sources, for example, do not capture recommendations that do not directly impact care and activities without billing codes (e.g. counseling, education), and have limited capacity to determine which provider ordered a test or consult. We seek to describe all documented services rendered by neurologists at outpatient encounters.
Design/Methods:
This is single-center retrospective chart review performed at a
large tertiary care academic center from Sep-2023 to Oct-2023. The most recent consecutive outpatient encounters to any neurologic provider were identified, and details of the plan (lab tests, imaging, medication changes, electrodiagnostic studies, and education/counseling) were abstracted via chart review using trained abstractors after ensuring high inter-rater reliability of all chart review elements. Data were summarized with descriptive statistics.
Results:
572 patient encounters were included in our analysis with an average age of 56.4 (SD 16.9). The most common specialty classifications of neurologists were general (170, 29.7%), headache (143, 25.0%) and neuromuscular (56, 9.8%). Of these encounters, a mean of 3.2 (SD 7.5) diagnostic services were documented per visit including 1.7 (SD 3.7) blood tests, 0.4 (SD 0.8) diagnostic imaging studies and 0.2 (SD 0.4)
electrodiagnostic tests. At each visit, the most common services rendered were medication changes (268,
46.9%), patient education (217, 38.0%), blood tests (164, 28.7%), imaging studies (161, 28.1%), and injections (34, 5.9%).
Conclusions:
In this large sample of outpatient visits at a tertiary medical center, we found that the services rendered by neurologists largely consisted of medication changes, patient education, blood tests, and imaging. To evaluate the value of neurologists’ services will require better understanding of the value of neurologic diagnosis and counseling/education.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.