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Resource Cost Utilization and One Year Outcomes Following Participation in a Community Cardiovascular Screening Program
Başlık:
Resource Cost Utilization and One Year Outcomes Following Participation in a Community Cardiovascular Screening Program
Yazar:
Bierig, S. Michelle, author.
ISBN:
9780438127906
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (73 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 79-11(E), Section: B.
Advisors: Thomas Burroughs Committee members: Eric Armbrecht; Anita Arnold.
Özet:
Problem: Despite advances in clinical cardiology and diagnostic imaging, cardiovascular disease is the leading cause of death in the United States. Early diagnosis provides the opportunity for early intervention and treatment of CVD. Unrecognized cardiac and vascular abnormalities can be detected through community cardiovascular screening programs but are not widely advocated due to the potential false positive results which would cause additional downstream testing and unnecessary costs. This prospective study investigates the demographics of participants of a community cardiovascular screening receiving carotid, aortic and cardiac ultrasound, EKG and ABI testing to determine one year cost and outcomes comparing benefit versus harm of the screening. Methods: Between 2014 to 2017, 205 participants enrolled with 68 (33.2%) having abnormal results in at least one of the following screening tests: Ankle Brachial Index 5 (2.5%); Carotid Ultrasound 13 (6.4%); Aortic Ultrasound 5 (2.5%) 3%; Electrocardiogram 23 (11.2%); Transthoracic echocardiography 45 (22.2%),
Results: Participants with abnormal imaging results more frequently had peripheral vascular disease (p=0.04), or take blood pressure medications (p=0.02). Household income was not a predictor of abnormal test result (p=0.18). Multivariate analysis for independent predictors of a positive/abnormal imaging test showed that when controlling for age greater than 75, blood pressure medications was the only predictor a positive test (OR 1.87 (1.01-3.46) p=0.05) (Table 3). Over the follow up period, 8 (24.2%) of those with a positive result had follow up cardiovascular-related testing within 30 days and 3 (3.7%) of those with a negative result had additional cardiovascular-related testing within 30 days. One year costs were similar between those with an initial normal or abnormal screen. The number of cardiac events did not differ significantly between those with a normal or abnormal screening result (p=0.72).
Conclusion: Early detection of cardiovascular disease through the use of community health screenings may be an effective tool for detecting subclinical disease and improving the health status of patients through proactive follow-up. Utilization of credentialed personnel and high end equipment with adherence to national standards of performance will optimize accuracy while minimizing false positive and false negative results.
Notlar:
School code: 0193
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(693796.1) | 693796-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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