BACKGROUND: While studies have been published in the last 30 years that examine the effect of charge display during physician decision-making, no analysis or synthesis of these studies has been conducted.OBJECTIVE: We aimed to determine the type and quality of charge display studies that have been published; to synthesize this information in the form of a literature review.METHODS: English-language articles published between 1982 and 2013 were identified using MEDLINE, Web of Knowledge, ABI-Inform, and Academic Search Premier. Article titles, abstracts, and text were reviewed for relevancy by two authors. Data were then extracted and subsequently synthesized and analyzed.RESULTS: Seventeen articles were identified that fell into two topic categories: the effect of charge display on radiology and laboratory test ordering versus on medication choice. Seven articles were randomized controlled trials, eight were pre-intervention vs. post-intervention studies, and two interventions had a concurrent control and intervention groups, but were not randomized. Twelve studies were conducted in a clinical environment, whereas five were survey studies. Of the nine clinically based interventions that examined test ordering, seven had statistically significant reductions in cost and/or the number of tests ordered. Two of the three clinical studies looking at medication expenditures found significant reductions in cost. In the survey studies, physicians consistently chose fewer tests or lower cost options in the theoretical scenarios presented.CONCLUSIONS: In the majority of studies, charge information changed ordering and prescribing behavior.
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机译:背景:尽管最近30年发表了研究,以检查电荷显示在医师决策过程中的作用,但尚未对这些研究进行分析或综合。目的:我们旨在确定电荷显示研究的类型和质量。已经出版的方法:以MEDLINE,Web of Knowledge,ABI-Inform和Academic Search Premier识别1982年至2013年之间发表的英语文章。两位作者审查了文章标题,摘要和文本的相关性。结果:共鉴定出十七篇文章,分为两个主题类别:电荷显示对放射学和实验室检查订购的影响以及对药物选择的影响。七篇文章为随机对照试验,八篇为干预前与干预后研究,两项干预措施同时具有对照组和干预组,但未随机分组。在临床环境中进行了十二项研究,而五项是调查研究。在检查测试订购的9种基于临床的干预措施中,有7项在成本和/或订购的检验数量上具有统计学上的显着降低。在研究药物支出的三项临床研究中,有两项发现成本显着降低。在调查研究中,医生在提出的理论方案中始终选择较少的测试或较低的费用选项。结论:在大多数研究中,收费信息会改变顺序和处方行为。
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