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October 2013; 3 (5) Eye on Practice

Expenditures in the elderly with peripheral neuropathy

Where should we focus cost-control efforts?

Brian C. Callaghan, James F. Burke, Ann Rodgers, Ryan McCammon, Kenneth M. Langa, Eva L. Feldman, Kevin A. Kerber
First published October 3, 2013, DOI: https://doi.org/10.1212/CPJ.0b013e3182a78fb1
Brian C. Callaghan
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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James F. Burke
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Ann Rodgers
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Ryan McCammon
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Kenneth M. Langa
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Eva L. Feldman
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Kevin A. Kerber
University of Michigan (BC, JB, AR, RM, KML, EF, KK); VA Center for Clinical Management Research (JB, KML); and Institute for Social Research (KML), Ann Arbor.
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Citation
Expenditures in the elderly with peripheral neuropathy
Where should we focus cost-control efforts?
Brian C. Callaghan, James F. Burke, Ann Rodgers, Ryan McCammon, Kenneth M. Langa, Eva L. Feldman, Kevin A. Kerber
Neurol Clin Pract Oct 2013, 3 (5) 421-430; DOI: 10.1212/CPJ.0b013e3182a78fb1

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Summary

To optimize care in the evaluation of peripheral neuropathy, we sought to define which tests drive expenditures and the role of the provider type. We investigated test utilization and expenditures by provider type in those with incident neuropathy in a nationally representative elderly, Medicare population. Multivariable logistic regression was used to determine predictors of MRI and electrodiagnostic utilization. MRIs of the neuroaxis and electrodiagnostic tests accounted for 88% of total expenditures. Mean and aggregate diagnostic expenditures were higher in those who saw a neurologist. Patients who saw a neurologist were more likely to receive an MRI and an electrodiagnostic test. MRIs and electrodiagnostic tests are the main contributors to expenditures in the evaluation of peripheral neuropathy, and should be the focus of future efficiency efforts.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • © 2013 American Academy of Neurology
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