Program cuts unnecessary referrals for scoliosis in teens

Louis Vernacchio, M.D., from the Pediatric Physicians' Organization at Children's in Brookline, Mass., and colleagues tracked referral patterns for AIS in the two years post-implementation of a quality improvement program consisting of physician education, decision support tools at the point of care, and longitudinal data feedback. Patterns were compared with those from the two years pre-intervention.

The researchers observed a significant, 20.4 percent decrease in the initial visits to orthopedic surgery for AIS (from 5.1 to 4.1 per 1,000 adolescents per year). After initiation of the program there was a rapid change in referral patterns, which was sustained over the two-year period. As a result of the program, 66 initial and 131 total AIS specialty visits were avoided.

"We found that a quality improvement program consisting of physician education, decision support available at the point of care, and longitudinal feedback of data on referral patterns substantially reduced unnecessary visits to orthopedic surgery for AIS," the authors write. "This approach could serve as a model for the development of other quality improvement programs that seek to shift the locus of care from specialty to primary care in an attempt to maintain or enhance value while reducing cost."

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Journal reference: Pediatrics

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