Expenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts?

TitleExpenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts?
Publication TypeJournal Article
Year of Publication2013
AuthorsCallaghan, BC, Burke, JF, Rodgers, A, McCammon, R, Langa, KM, Feldman, E, Kerber, K
JournalNeurology. Clinical Practice
Volume3
Issue5
Pagination421-430
Date Published2013 Oct
ISSN Number2163-0402
KeywordsMedical Expenses, Medicare/Medicaid/Health Insurance, Older Adults, Peripheral Neuropathy
Abstract

To optimize care in the evaluation of peripheral neuropathy, we sought to define which tests drive expenditures and the role of the provider type. We investigated test utilization and expenditures by provider type in those with incident neuropathy in a nationally representative elderly, Medicare population. Multivariable logistic regression was used to determine predictors of MRI and electrodiagnostic utilization. MRIs of the neuroaxis and electrodiagnostic tests accounted for 88% of total expenditures. Mean and aggregate diagnostic expenditures were higher in those who saw a neurologist. Patients who saw a neurologist were more likely to receive an MRI and an electrodiagnostic test. MRIs and electrodiagnostic tests are the main contributors to expenditures in the evaluation of peripheral neuropathy, and should be the focus of future efficiency efforts.

DOI10.1212/CPJ.0b013e3182a78fb1
Alternate JournalNeurol Clin Pract
Citation Key8930
PubMed ID24175158
PubMed Central IDPMC3806930
Grant ListP30 DK020572 / DK / NIDDK NIH HHS / United States