Initial genitourinary (GU) physical examinations are performed in less than a third of cases prior to requesting a urologic consultation, and this rate is affected by patient age and sex, according to research published in the December issue of Urology.
Adam W. Ylitalo, DO, of the Detroit Medical Center, and colleagues conducted a retrospective study involving 420 consecutive patients who were evaluated by the urology consultation service over a six-week period, after being seen by an emergency department or primary hospital team. The frequency of GU physical examination was recorded and demographic and clinical factors assessed.
The researchers found that, of the 357 patients requiring a urologic consultation, 27 and 31 percent had a GU physical examination performed by the emergency department or primary hospital team, respectively. Compared with women, men were six times more likely to receive a GU physical exam in the emergency department and twice as likely to receive a GU physical exam by the primary hospital team. Older patients were less likely than younger patients to receive an examination by either team. No differences in examination rates were found for patients of different races.
"The results of our study indicate that examinations are performed less than one-third of the time before obtaining a urologic consultation, with the frequency related to age and sex," the authors write. "The low rate of pre-consultation examination creates concern for quality of care, the correctness of billing, and unnecessary urologic consultations."
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