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To define the most cost-effective means of diagnosing and following gastric ulcers, both benign and malignant, the University of Utah Medical Center (UUMC) experience between September 1980 and October 1983 was reviewed. Endoscopy (EGD) was utilized in the initial evaluation process in 96% of patients. Follow-up was performed by either a combination of EGD and double contrast upper GI (DCUGI) or EGD alone. Diagnostic and follow-up modality had no effect on survival. It appears that the high-frequency use of EGD for gastric ulcer management is not cost-effective. We suggest an algorithm in which EGD would be used only following failure either to demonstrate characteristic benign appearance on DCUGI or inadequate healing following therapeutic trial. A theoretical net savings of 55% is calculated by retrospective application of the algorithm to the UUMC experience; 30% savings is realized for diagnosis and 81% for follow-up. If adopted on a national scale, the algorithm proposed may result in a significant savings in health-care cost.
W G Armington, and
F A Mann, and
J A Nelson
November 1971,
Laval medical,
W G Armington, and
F A Mann, and
J A Nelson
January 1951,
Revista espanola de las enfermedades del aparato digestivo y de la nutricion,
W G Armington, and
F A Mann, and
J A Nelson
January 1956,
Ciba clinical symposia,
W G Armington, and
F A Mann, and
J A Nelson
April 1974,
Geriatrics,
W G Armington, and
F A Mann, and
J A Nelson
March 1950,
Surgery, gynecology & obstetrics,
W G Armington, and
F A Mann, and
J A Nelson
April 1963,
Klinicheskaia meditsina,
W G Armington, and
F A Mann, and
J A Nelson
April 1971,
Seminars in roentgenology,
W G Armington, and
F A Mann, and
J A Nelson
September 1977,
ZFA. Zeitschrift fur Allgemeinmedizin,
W G Armington, and
F A Mann, and
J A Nelson
October 1953,
Gastroenterology,
W G Armington, and
F A Mann, and
J A Nelson
February 1953,
Journal of the National Cancer Institute,
