Loading…
Screening Dipstick Urinalysis: A Time to Change
This study attempted to determine the minimal cost of screening dipstick urinalyses in a hypothetical cohort of 2000 asymptomatic pediatric patients in a primary care setting. The minimal cost utilizing a private practitioner in an urban or suburban group pediatric setting was calculated. Costs were...
Saved in:
Published in: | Pediatrics (Evanston) 1997-12, Vol.100 (6), p.919-921 |
---|---|
Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3 |
---|---|
cites | cdi_FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3 |
container_end_page | 921 |
container_issue | 6 |
container_start_page | 919 |
container_title | Pediatrics (Evanston) |
container_volume | 100 |
creator | Kaplan, Robert E Springate, James E Feld, Leonard G |
description | This study attempted to determine the minimal cost of screening dipstick urinalyses in a hypothetical cohort of 2000 asymptomatic pediatric patients in a primary care setting.
The minimal cost utilizing a private practitioner in an urban or suburban group pediatric setting was calculated. Costs were determined by using current charges for supplies ordered to perform tests in the office, charges for tests performed by a commercial laboratory, and the cost of an initial evaluation by a pediatric nephrologist. Data from published studies were also utilized.
Nine percent (179/2000) of patients were calculated to have an initial abnormal urinalysis. Upon retesting only 1.5% (29/2000) of patients were calculated to have a persistent abnormality. The calculated rate of a false positive/transient abnormality for all patients in the hypothetical cohort of 2000 asymptomatic pediatric patients was 84% (150/179). The calculated minimal cost for the outpatient evaluation of 2000 asymptomatic pediatric patients by dipstick urinalyses ranged between $5022 to $6475. The range depends on whether 50% versus 100% of patients with a repeat abnormal dipstick urinalysis were referred to a pediatric nephrologist for further evaluation. The calculated cost was $1290 to initially screen all 2000 patients with a dipstick urinalysis or 65 cents per patient. The calculated cost to evaluate the 29 patients with any persistent abnormality on repeat dipstick urinalysis was $3732 to $5185 or $129 to $179 per patient. This is the calculated cost for a single screening of 2000 asymptomatic pediatric patients. The calculated cost for four multiple screening urinalyses as currently recommended is $20 088 to $25 900. Additionally, these are only minimal initial calculated costs. Costs of any renal imagining or function studies ordered by the pediatric nephrologist or the pediatrician pursuing a further evaluation on his/her own were not included.
Multiple screening dipstick urinalyses in asymptomatic pediatric patients are costly and should be discontinued. In their place, we propose that a single screening dipstick urinalysis be obtained at school entry age, between 5 and 6 years old, in all asymptomatic children. The sample should be a first morning void. |
doi_str_mv | 10.1542/peds.100.6.919 |
format | article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_79438589</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A20132221</galeid><sourcerecordid>A20132221</sourcerecordid><originalsourceid>FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3</originalsourceid><addsrcrecordid>eNpt0c1v0zAUAHALgUYZXLkhRQghDkvmjziOuVUFBlKlHdjOlmO_pB5O0tmJYP89rlptFFXv4I_3s5_lh9BbggvCS3q5BRsLgnFRFZLIZ2hBsKzzkgr-HC0wZiQvMeYv0asY7zDGJRf0DJ1JJkrOxQJd_jQBYHBDl31x2zg58yu7DW7Q_iG6-DlbZjeuh2was9VGDx28Ri9a7SO8OYzn6Pbb15vV93x9ffVjtVznhjM85YCt5bLBtYWK8bqVhNcprKiYbpoGNK24IUK0bVM1VAOpLOXcVg2IhtTSsnP0cX_vNoz3M8RJ9S4a8F4PMM5RCVmydKNM8P1_8G6cQ3p_VJTWrMQlYQld7FGnPSg3tOMUtOlggKD9OEDr0vaSYsIopSTx_ARPYaF35pT_dOQTmeDP1Ok5RlVfrY_oxSlqRu-hA5X-cHV9xIs9N2GMMUCrtsH1OjwogtWu_2rX_7TAqlKp_-nAu8N3zE0P9pEfGp7yHw55HY32bdCDcfGRUSwFl-yp7sZ1m98uwK6O01NwJv4zfar7F1r_xEM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>228340413</pqid></control><display><type>article</type><title>Screening Dipstick Urinalysis: A Time to Change</title><source>EZB Free E-Journals</source><creator>Kaplan, Robert E ; Springate, James E ; Feld, Leonard G</creator><creatorcontrib>Kaplan, Robert E ; Springate, James E ; Feld, Leonard G</creatorcontrib><description>This study attempted to determine the minimal cost of screening dipstick urinalyses in a hypothetical cohort of 2000 asymptomatic pediatric patients in a primary care setting.
The minimal cost utilizing a private practitioner in an urban or suburban group pediatric setting was calculated. Costs were determined by using current charges for supplies ordered to perform tests in the office, charges for tests performed by a commercial laboratory, and the cost of an initial evaluation by a pediatric nephrologist. Data from published studies were also utilized.
Nine percent (179/2000) of patients were calculated to have an initial abnormal urinalysis. Upon retesting only 1.5% (29/2000) of patients were calculated to have a persistent abnormality. The calculated rate of a false positive/transient abnormality for all patients in the hypothetical cohort of 2000 asymptomatic pediatric patients was 84% (150/179). The calculated minimal cost for the outpatient evaluation of 2000 asymptomatic pediatric patients by dipstick urinalyses ranged between $5022 to $6475. The range depends on whether 50% versus 100% of patients with a repeat abnormal dipstick urinalysis were referred to a pediatric nephrologist for further evaluation. The calculated cost was $1290 to initially screen all 2000 patients with a dipstick urinalysis or 65 cents per patient. The calculated cost to evaluate the 29 patients with any persistent abnormality on repeat dipstick urinalysis was $3732 to $5185 or $129 to $179 per patient. This is the calculated cost for a single screening of 2000 asymptomatic pediatric patients. The calculated cost for four multiple screening urinalyses as currently recommended is $20 088 to $25 900. Additionally, these are only minimal initial calculated costs. Costs of any renal imagining or function studies ordered by the pediatric nephrologist or the pediatrician pursuing a further evaluation on his/her own were not included.
Multiple screening dipstick urinalyses in asymptomatic pediatric patients are costly and should be discontinued. In their place, we propose that a single screening dipstick urinalysis be obtained at school entry age, between 5 and 6 years old, in all asymptomatic children. The sample should be a first morning void.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.100.6.919</identifier><identifier>PMID: 9374557</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: Am Acad Pediatrics</publisher><subject>Analysis ; Biological and medical sciences ; Child ; Children ; Cost-Benefit Analysis ; Direct Service Costs ; Health care expenditures ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Mass Screening - economics ; Mass Screening - statistics & numerical data ; Medical examination ; Medical sciences ; Medical screening ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Pediatrics ; Pediatrics - economics ; Pediatrics - methods ; Reagent Strips - economics ; Urinalysis ; Urinalysis - economics ; Urinalysis - statistics & numerical data ; Urinary system ; Urine</subject><ispartof>Pediatrics (Evanston), 1997-12, Vol.100 (6), p.919-921</ispartof><rights>1998 INIST-CNRS</rights><rights>COPYRIGHT 1997 American Academy of Pediatrics</rights><rights>COPYRIGHT 1997 American Academy of Pediatrics</rights><rights>Copyright American Academy of Pediatrics Dec 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3</citedby><cites>FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2097593$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9374557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaplan, Robert E</creatorcontrib><creatorcontrib>Springate, James E</creatorcontrib><creatorcontrib>Feld, Leonard G</creatorcontrib><title>Screening Dipstick Urinalysis: A Time to Change</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>This study attempted to determine the minimal cost of screening dipstick urinalyses in a hypothetical cohort of 2000 asymptomatic pediatric patients in a primary care setting.
The minimal cost utilizing a private practitioner in an urban or suburban group pediatric setting was calculated. Costs were determined by using current charges for supplies ordered to perform tests in the office, charges for tests performed by a commercial laboratory, and the cost of an initial evaluation by a pediatric nephrologist. Data from published studies were also utilized.
Nine percent (179/2000) of patients were calculated to have an initial abnormal urinalysis. Upon retesting only 1.5% (29/2000) of patients were calculated to have a persistent abnormality. The calculated rate of a false positive/transient abnormality for all patients in the hypothetical cohort of 2000 asymptomatic pediatric patients was 84% (150/179). The calculated minimal cost for the outpatient evaluation of 2000 asymptomatic pediatric patients by dipstick urinalyses ranged between $5022 to $6475. The range depends on whether 50% versus 100% of patients with a repeat abnormal dipstick urinalysis were referred to a pediatric nephrologist for further evaluation. The calculated cost was $1290 to initially screen all 2000 patients with a dipstick urinalysis or 65 cents per patient. The calculated cost to evaluate the 29 patients with any persistent abnormality on repeat dipstick urinalysis was $3732 to $5185 or $129 to $179 per patient. This is the calculated cost for a single screening of 2000 asymptomatic pediatric patients. The calculated cost for four multiple screening urinalyses as currently recommended is $20 088 to $25 900. Additionally, these are only minimal initial calculated costs. Costs of any renal imagining or function studies ordered by the pediatric nephrologist or the pediatrician pursuing a further evaluation on his/her own were not included.
Multiple screening dipstick urinalyses in asymptomatic pediatric patients are costly and should be discontinued. In their place, we propose that a single screening dipstick urinalysis be obtained at school entry age, between 5 and 6 years old, in all asymptomatic children. The sample should be a first morning void.</description><subject>Analysis</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Children</subject><subject>Cost-Benefit Analysis</subject><subject>Direct Service Costs</subject><subject>Health care expenditures</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Mass Screening - economics</subject><subject>Mass Screening - statistics & numerical data</subject><subject>Medical examination</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Pediatrics</subject><subject>Pediatrics - economics</subject><subject>Pediatrics - methods</subject><subject>Reagent Strips - economics</subject><subject>Urinalysis</subject><subject>Urinalysis - economics</subject><subject>Urinalysis - statistics & numerical data</subject><subject>Urinary system</subject><subject>Urine</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNpt0c1v0zAUAHALgUYZXLkhRQghDkvmjziOuVUFBlKlHdjOlmO_pB5O0tmJYP89rlptFFXv4I_3s5_lh9BbggvCS3q5BRsLgnFRFZLIZ2hBsKzzkgr-HC0wZiQvMeYv0asY7zDGJRf0DJ1JJkrOxQJd_jQBYHBDl31x2zg58yu7DW7Q_iG6-DlbZjeuh2was9VGDx28Ri9a7SO8OYzn6Pbb15vV93x9ffVjtVznhjM85YCt5bLBtYWK8bqVhNcprKiYbpoGNK24IUK0bVM1VAOpLOXcVg2IhtTSsnP0cX_vNoz3M8RJ9S4a8F4PMM5RCVmydKNM8P1_8G6cQ3p_VJTWrMQlYQld7FGnPSg3tOMUtOlggKD9OEDr0vaSYsIopSTx_ARPYaF35pT_dOQTmeDP1Ok5RlVfrY_oxSlqRu-hA5X-cHV9xIs9N2GMMUCrtsH1OjwogtWu_2rX_7TAqlKp_-nAu8N3zE0P9pEfGp7yHw55HY32bdCDcfGRUSwFl-yp7sZ1m98uwK6O01NwJv4zfar7F1r_xEM</recordid><startdate>19971201</startdate><enddate>19971201</enddate><creator>Kaplan, Robert E</creator><creator>Springate, James E</creator><creator>Feld, Leonard G</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19971201</creationdate><title>Screening Dipstick Urinalysis: A Time to Change</title><author>Kaplan, Robert E ; Springate, James E ; Feld, Leonard G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Analysis</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Children</topic><topic>Cost-Benefit Analysis</topic><topic>Direct Service Costs</topic><topic>Health care expenditures</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Mass Screening - economics</topic><topic>Mass Screening - statistics & numerical data</topic><topic>Medical examination</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Pediatrics</topic><topic>Pediatrics - economics</topic><topic>Pediatrics - methods</topic><topic>Reagent Strips - economics</topic><topic>Urinalysis</topic><topic>Urinalysis - economics</topic><topic>Urinalysis - statistics & numerical data</topic><topic>Urinary system</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaplan, Robert E</creatorcontrib><creatorcontrib>Springate, James E</creatorcontrib><creatorcontrib>Feld, Leonard G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaplan, Robert E</au><au>Springate, James E</au><au>Feld, Leonard G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening Dipstick Urinalysis: A Time to Change</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>1997-12-01</date><risdate>1997</risdate><volume>100</volume><issue>6</issue><spage>919</spage><epage>921</epage><pages>919-921</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>This study attempted to determine the minimal cost of screening dipstick urinalyses in a hypothetical cohort of 2000 asymptomatic pediatric patients in a primary care setting.
The minimal cost utilizing a private practitioner in an urban or suburban group pediatric setting was calculated. Costs were determined by using current charges for supplies ordered to perform tests in the office, charges for tests performed by a commercial laboratory, and the cost of an initial evaluation by a pediatric nephrologist. Data from published studies were also utilized.
Nine percent (179/2000) of patients were calculated to have an initial abnormal urinalysis. Upon retesting only 1.5% (29/2000) of patients were calculated to have a persistent abnormality. The calculated rate of a false positive/transient abnormality for all patients in the hypothetical cohort of 2000 asymptomatic pediatric patients was 84% (150/179). The calculated minimal cost for the outpatient evaluation of 2000 asymptomatic pediatric patients by dipstick urinalyses ranged between $5022 to $6475. The range depends on whether 50% versus 100% of patients with a repeat abnormal dipstick urinalysis were referred to a pediatric nephrologist for further evaluation. The calculated cost was $1290 to initially screen all 2000 patients with a dipstick urinalysis or 65 cents per patient. The calculated cost to evaluate the 29 patients with any persistent abnormality on repeat dipstick urinalysis was $3732 to $5185 or $129 to $179 per patient. This is the calculated cost for a single screening of 2000 asymptomatic pediatric patients. The calculated cost for four multiple screening urinalyses as currently recommended is $20 088 to $25 900. Additionally, these are only minimal initial calculated costs. Costs of any renal imagining or function studies ordered by the pediatric nephrologist or the pediatrician pursuing a further evaluation on his/her own were not included.
Multiple screening dipstick urinalyses in asymptomatic pediatric patients are costly and should be discontinued. In their place, we propose that a single screening dipstick urinalysis be obtained at school entry age, between 5 and 6 years old, in all asymptomatic children. The sample should be a first morning void.</abstract><cop>Elk Grove Village, IL</cop><pub>Am Acad Pediatrics</pub><pmid>9374557</pmid><doi>10.1542/peds.100.6.919</doi><tpages>3</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0031-4005 |
ispartof | Pediatrics (Evanston), 1997-12, Vol.100 (6), p.919-921 |
issn | 0031-4005 1098-4275 |
language | eng |
recordid | cdi_proquest_miscellaneous_79438589 |
source | EZB Free E-Journals |
subjects | Analysis Biological and medical sciences Child Children Cost-Benefit Analysis Direct Service Costs Health care expenditures Humans Investigative techniques, diagnostic techniques (general aspects) Mass Screening - economics Mass Screening - statistics & numerical data Medical examination Medical sciences Medical screening Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Pediatrics Pediatrics - economics Pediatrics - methods Reagent Strips - economics Urinalysis Urinalysis - economics Urinalysis - statistics & numerical data Urinary system Urine |
title | Screening Dipstick Urinalysis: A Time to Change |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T22%3A10%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Screening%20Dipstick%20Urinalysis:%20A%20Time%20to%20Change&rft.jtitle=Pediatrics%20(Evanston)&rft.au=Kaplan,%20Robert%20E&rft.date=1997-12-01&rft.volume=100&rft.issue=6&rft.spage=919&rft.epage=921&rft.pages=919-921&rft.issn=0031-4005&rft.eissn=1098-4275&rft.coden=PEDIAU&rft_id=info:doi/10.1542/peds.100.6.919&rft_dat=%3Cgale_proqu%3EA20132221%3C/gale_proqu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c530t-e0dd59b08de6358f9158585d763abbbea265c177ffb6b2ae16d255d6be7b189d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=228340413&rft_id=info:pmid/9374557&rft_galeid=A20132221&rfr_iscdi=true |