Abstract：
OBJECTIVE: Second-opinion pathology review identifies clinically significant diagnostic discrepancies for some patients. Discrepancy rates and laboratory-specific costs in a single health care system for patients referred from regional affiliates to a comprehensive cancer center (\"main campus\") have not been reported.
METHODS: Main campus second-opinion pathology cases for 740 patients from eight affiliated hospitals during 2016 to 2018 were reviewed. Chart review was performed to identify changes in care due to pathology review. To assess costs of pathology interpretation, reimbursement rates for consultation Current Procedural Terminology billing codes were compared with codes that would have been used had the cases originated at the main campus.
RESULTS: Diagnostic discrepancies were identified in 104 (14.1%) patients, 30 (4.1%) of which resulted in a change in care. In aggregate, reimbursement for affiliate cases was 65.6% of the reimbursement for the same cases had they originated at the main campus. High-volume organ systems with low relative consultation reimbursement included gynecologic, breast, and thoracic.
CONCLUSIONS: Preventable diagnostic errors are reduced by pathology review for patients referred within a single health care system. Although the resulting changes in care potentially lead to overall cost savings, the financial value of referral pathology review could be improved.
METHODS: Main campus second-opinion pathology cases for 740 patients from eight affiliated hospitals during 2016 to 2018 were reviewed. Chart review was performed to identify changes in care due to pathology review. To assess costs of pathology interpretation, reimbursement rates for consultation Current Procedural Terminology billing codes were compared with codes that would have been used had the cases originated at the main campus.
RESULTS: Diagnostic discrepancies were identified in 104 (14.1%) patients, 30 (4.1%) of which resulted in a change in care. In aggregate, reimbursement for affiliate cases was 65.6% of the reimbursement for the same cases had they originated at the main campus. High-volume organ systems with low relative consultation reimbursement included gynecologic, breast, and thoracic.
CONCLUSIONS: Preventable diagnostic errors are reduced by pathology review for patients referred within a single health care system. Although the resulting changes in care potentially lead to overall cost savings, the financial value of referral pathology review could be improved.
摘要：
目的：第二意见病理学回顾发现了一些患者的临床诊断差异。从地区附属机构转到综合癌症中心（“主校区”）的患者的单一医疗保健系统中的差异率和实验室特定费用尚未报告。
方法：对2016年至2018年8家附属医院740例患者的主校区第二意见病理病例进行回顾性分析。进行图表审查以确定由于病理审查引起的护理变化。为了评估病理解释的成本，咨询的偿还率将当前程序术语账单代码与如果案件起源于主校园的代码进行了比较。
结果：在104例（14.1%）患者中发现了诊断差异，其中30人（4.1%）导致护理发生变化。总的来说,关联案例的报销额占同一案例在主校区的报销额的65.6％。相对咨询报销较低的高容量器官系统包括妇科，乳房,和胸廓。
结论：对于在单一医疗保健系统中转诊的患者，可通过病理学检查减少可预防的诊断错误。尽管由此产生的护理变化可能会节省整体成本，转诊病理审查的财务价值可以提高.
方法：对2016年至2018年8家附属医院740例患者的主校区第二意见病理病例进行回顾性分析。进行图表审查以确定由于病理审查引起的护理变化。为了评估病理解释的成本，咨询的偿还率将当前程序术语账单代码与如果案件起源于主校园的代码进行了比较。
结果：在104例（14.1%）患者中发现了诊断差异，其中30人（4.1%）导致护理发生变化。总的来说,关联案例的报销额占同一案例在主校区的报销额的65.6％。相对咨询报销较低的高容量器官系统包括妇科，乳房,和胸廓。
结论：对于在单一医疗保健系统中转诊的患者，可通过病理学检查减少可预防的诊断错误。尽管由此产生的护理变化可能会节省整体成本，转诊病理审查的财务价值可以提高.
