Abstract Details

Title Evaluation of Neurologist Care Delivery: A Single Academic Center Exploratory Study

Topic General Neurology

Presentation(s) P6 - Poster Session 6 (11:45 AM-12:45 PM)

Poster/Presentation
Number 2-006

Objective To characterize services rendered by neurologists at clinical evaluations to inform the value of neurologic care.

Background Characterizing elements of neurologic care and thus the overall value of neurologic care is challenging due to measurement limitations. Administrative data sources, for example, do not capture recommendations that do not directly impact care and activities without billing codes (e.g. counseling, education), and have limited capacity to determine which provider ordered a test or consult. We seek to describe all documented services rendered by neurologists at outpatient encounters.

Design/Methods This is single-center retrospective chart review performed at a large tertiary care academic center from Sep-2023 to Oct-2023. The most recent consecutive outpatient encounters to any neurologic provider were identified, and details of the plan (lab tests, imaging, medication changes, electrodiagnostic studies, and education/counseling) were abstracted via chart review using trained abstractors after ensuring high inter-rater reliability of all chart review elements. Data were summarized with descriptive statistics.

Results 572 patient encounters were included in our analysis with an average age of 56.4 (SD 16.9). The most common specialty classifications of neurologists were general (170, 29.7%), headache (143, 25.0%) and neuromuscular (56, 9.8%). Of these encounters, a mean of 3.2 (SD 7.5) diagnostic services were documented per visit including 1.7 (SD 3.7) blood tests, 0.4 (SD 0.8) diagnostic imaging studies and 0.2 (SD 0.4) electrodiagnostic tests. At each visit, the most common services rendered were medication changes (268, 46.9%), patient education (217, 38.0%), blood tests (164, 28.7%), imaging studies (161, 28.1%), and injections (34, 5.9%).

Conclusions

In this large sample of outpatient visits at a tertiary medical center, we found that the services rendered by neurologists largely consisted of medication changes, patient education, blood tests, and imaging. To evaluate the value of neurologists’ services will require better understanding of the value of neurologic diagnosis and counseling/education.

Authors/Disclosures
Andrew George PRESENTER	Mr. George has nothing to disclose.
Raed S. Hailat, MD, PhD	Dr. Hailat has nothing to disclose.
Ankit R. Annapareddy, BS	Mr. Annapareddy has received personal compensation for serving as an employee of Blueprint Test Prep.
Benjamin Templeton	Mr. Templeton has nothing to disclose.
Nicholas Capaci, MD (Ohio State University Wexner Medical Center)	Dr. Capaci has nothing to disclose.
Terese Gullo, MD (Ohio State)	Miss Gullo has nothing to disclose.
James F. Burke, MD (Ohio State Wexner Medical Center)	Dr. Burke has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association/Circulation: Cardiovascular quality and outcomes. The institution of Dr. Burke has received research support from Genentech Foundation. The institution of Dr. Burke has received research support from NIH.
Kevin A. Kerber, MD (Ohio State University Department of Neurology)	Dr. Kerber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for American Academy of Neurology. The institution of Dr. Kerber has received research support from National Institutes of Health. The institution of Dr. Kerber has received research support from Genentech, Inc . Dr. Kerber has received publishing royalties from a publication relating to health care.