EVOKED-POTENTIALS IN PEDIATRICS - ECONOMIC AUDIT

In the present era of resource management, there is increasing emphasi s on the need to make the best possible use of available resources. We therefore measured the productive factors directly involved in perfor mance of 59 evoked potential examinations (brainstem auditory evoked p otentials, BAEPs; flash visual evoked potentials, F-VEPs; and electror etinograms, ERGs) in different pediatric age groups. In order to ascer tain the gap between the costs of instrumental examinations performed in our service on children and the fees reimbursed by the Italian nati onal health service (NHS) a breakdown was made of the costs of tests a nd their scheduling in relation to the different age variables involve d. It was found that the fees reimbursed do not cover the real costs, because they underestimate the actual consumption of resources. The fi ndings recorded indicate that for pediatric tests the economic audit s hould be graded according to the ages of the children examined and sho uld include an analysis of different test phases. The economic audit s hould also be considered a preliminary step in clinical audit. It is c oncluded that it is financially punitive to reimburse a pediatric serv ice with a fee based on the examination of adults, because in pediatri cs the variable ''age'' influences the duration and complexity of test s and also their interpretation.