Cost Analysis for Endoscopic Retrograde Cholangiopancreatography (ERCP)

NCT02127229 | Withdrawn

• 1 other identifier: 574462
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of the study is to determine if endoscopist notification of accessory cost results in altered resource utilization related to the total cost and number of accessories used in ERCP. This study will be a prospective cost--analysis study. Only chart review of PHI removed records will be used. The only intervention used is that endoscopists will be made aware of the cost of accessories used in the second phase of the study following each ERCP. The investigators are in an era of increased medical cost consciousness. Medical education and post--graduate education incorporates cost savings and appropriate diagnostic test selection based on expense as one aspects of the decision process. This era now focuses on what is best for the patient with the understanding that the cost to the patient and cost to the overall health care system matters. Not only is this apart of postgraduate training but now being implemented as part of Medicare reimbursement to provide low cost and high quality care. Incidence of pancreatic and biliary disease is increasing. ERCP is a vital tool for therapeutic intervention. The costs of these procedures, to both patients and hospitals, have caused some to question the amount of accessories used as well as the poor reimbursement provided by Medicare and insurers. Studies have indicated that hospitals actually lose money with each ERCP used and their use is being limited many times to tertiary care centers.

Conditions

Biliary Obstruction

Keywords

endoscopic retrograde cholangiopancreatography; disposable accessory cost; endoscopy cost analysis

Outcome Measures

Primary Outcomes (1)

• Reduction of total cost of disposable accessories used for individual ERCP procedures

  Two arms in the study. One arm is observation of blinding endoscopists and calculating cost of disposable accessories used while performing ERCP. The other arm will be the intervention group. Before the intervention period begins, advanced endoscopists will be informed that there cost is being monitored for each ERCP and the cost of disposable accessories. Following each ERCP during the intervention group, the endoscopists will be informed of the cost of that individual procedure based on disposable accessories.

  ERCP procedures will be observed for up to 3 months for each arms of study

Secondary Outcomes (1)

• Cost identification of disposable accessory use in ERCP

  ERCP procedures will be observed for up to 3 months for each arms of study

Study Arms (2)

Blinded observation of ERCP

NO INTERVENTION

Blind observation of disposable accessories use.

Endoscopist informed of cost per procedure

EXPERIMENTAL

Endoscopists informed following each ERCP.

Procedure: Endoscopist informed of cost per procedure

Interventions

Endoscopist informed of cost per procedure PROCEDURE

Following each procedure, endoscopists will get a cost report regarding the amount spent on disposable accessories.

Endoscopist informed of cost per procedure

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult receiving ERCP at Endoscopy diagnostic center.

You may not qualify if:

• No stent removal or replacement procedures. EUS can only be used for intubation of bile duct. No spyglass will added to total cost.

Sponsors & Collaborators

• University of Oklahoma: lead

Study Sites (1)

University of Oklahoma Health Science Center

Oklahoma City, Oklahoma, 73104, United States

Location

Study Officials

• William Tierney, MD

  University of Oklahoma

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 4, 2014
• First Posted: April 30, 2014
• Study Start: April 1, 2014
• Primary Completion: September 1, 2014
• Study Completion: September 1, 2014
• Last Updated: August 28, 2017

Record last verified: 2017-08

Locations

US (1)