The impact of ‘best-practice’ patient care in fibromyalgia on practice economics
Brown, T., Garg, S., Chandran, A. B., McNett, M., Silverman, S. L., & Hadker, N. (2012). The impact of ‘best-practice’ patient care in fibromyalgia on practice economics. Journal of Evaluation in Clinical Practice, 18(4), 793-798. DOI: 10.1111/j.1365-2753.2011.01678.x
Objective. The office time required for primary care physicians (PCPs) to diagnose, treat and manage fibromyalgia (FM) patients can be extensive. The study objective was to determine if PCPs can positively impact practice economics by requiring fewer patient visits and less office time, while still achieving an acceptable quality of life, as reported by the physician.
Study Design. Survey of PCPs who diagnose, manage and treat FM patients.
Methods. Surveys were administered to US private practice PCPs, obtaining information on the number of office visits, and time spent with FM patients. PCPs were allotted into two groups: FM-efficient (FME; n = 40) and FM usual care (FMUC; n = 54), based on their reported ability to achieve an acceptable quality of life for ?50% of their FM patients in less than four office visits post FM diagnosis. An economic model estimated the monetary value of each PCP cohorts' time spent with a newly diagnosed FM patient over a 2-year timeframe.
Results. Significant office time cost differences across 2 years exist between FME PCPs and FMUC PCPs ($840 vs. $1117, P < 0.05). FME PCPs had a significantly lower cost of scheduled time to confirm diagnosis ($243 vs. $339, P < 0.05) and time to find right treatment ($264 vs. $365, P < 0.05) than FMUC PCPs. Both groups incurred costs related to excess visit time, but it was less for FME PCPs ($119, 29 minutes) than FMUC PCPs ($182, 44 minutes, P < 0.01), driven by quicker diagnosis confirmation (P < 0.01) and treatment initiation (P < 0.01).
Conclusions. Research suggests that efficient FM care delivery during diagnosis and treatment can be associated with improved practice economics.