An Efficient Strategy for Managing Acute Respiratory Illness in Adults

doi:10.1059/0003-4819-93-5-757

An Efficient Strategy for Managing Acute Respiratory Illness in Adults

Seattle, Washington; and San Antonio, Texas
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Abstract

A safe, effective, and efficient clinical algorithm (management rule) for the care of adults with acute respiratory illness by nonphysician providers is presented. The algorithm was created from a data base collected on more than 5000 patients and prospectively evaluated on an additional 2637. It eliminates unhelpful diagnostic tests and minimizes physician involvement in patient care without compromising clinical standards, illness outcome, or patient satisfaction. Total direct medical care costs when the algorithm was used were approximately 40% of those costs generated by physicians managing similar patients, primarily because the algorithm directed an 80% reduction in a diagnostic test costs. The results suggest that significant savings can result when algorithms are used in the care of ambulatory patients with common illnesses.

Article and Author Information

▸From the Department of Health Services Research, U.S. Public Health Service Hospital, and the Departments of Health Services and Medicine, University of Washington, Seattle, Washington; and the Department of Medicine, Brooke Army Medical Center, San Antonio, Texas.
Grant support: in part by funds from contracts DADA11-76-C-0003, DADA11-77-C-0008, and DADA11-78-C-OO09 between Brooke Army Medical Center and the University of Washington Department of Health Services.
All opinions expressed in this paper are the authors' and do not represent policy of either the Department of Health and Human Services or the U.S. Army.
▸Requests for reprints should be addressed to Robert W. Wood, M.D.; Health Services Research, U.S. Public Health Service Hospital, P.O. Box 3145; Seattle, WA 98114.