Cazzaniga P, Arienta C, Bevilacqua L, Minella C, Venegoni M; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1997; 13: 91.

Unita Operativa de Valutazione della Qualita. Ospedale Fatebenefratelli, Milan, Italy.

BACKGROUND: In 1994 a multicenter survey on the incidence of the minor head trauma and the use of diagnostic technologies was carried out in the emergency room of 27 hospitals of the Milan area. In all, 1590 patients were studied: sociodemographic data, clinical presentation, utilisation of skull X-ray and TC scan were collected. On the basis of this study a consensus conference prepared a guideline of the management of the minor head trauma. OBJECTIVES: A new multicenter study is under way in these same 27 hospitals; its objectives are: 1) to optimize the appropriateness of use of diagnostic technologies with regard to the clinical picture; 2) to obtain better customer satisfaction; 3) to obtain good diagnostic process at the lowest cost. A pilot study was carried out at Fatebenefratelli Hospital. METHODS: In the Fatebenefratelli Hospital the guidelines on the minor head trauma forsee performing a skull TC scan in the presence of specific signs of symptoms of risk factors, strongly reducing the need for skull X-ray. These guidelines are operative as from March 1st, 1996. An evaluation of the first two months was performed; after this, analysis was made during a fortnight every two months, to monitor the trend of the compliance with the guidelines. RESULTS: 1316 patients with head trauma, averaging 38.2 years, were studied in the period March-December 1996; of these, 1208 (91.8%) were diagnosed as having a minor head trauma. We observed a frequency of skull X-ray of 19.8%, compared to the 95% of the previous survey. The frequency of skull TC scan did not increase (27.8% compared to the previous 31%). CONCLUSIONS: The introduction of the guidelines on the management of the minor head trauma determined an important reduction of use of skull X-ray, without an increase of CT scan utilisation, a definite reduction of costs and time loss for the diagnosis, a better utilisation of nurses, resulting in better service to the patients. The multicenter study, which is in progress, will have to confirm this data. The results will be communicated at the meeting.

Publication Types:

• Meeting Abstracts

Keywords:

• Costs and Cost Analysis
• Craniocerebral Trauma
• Guidelines as Topic
• Humans
• Multicenter Study
• Risk Factors
• Skull
• Tomography, X-Ray Computed
• diagnosis
• economics
• methods
• radiography
• standards
• hsrmtgs

Other ID:

• HTX/98601585

UI: 102233126

From Meeting Abstracts