• J A Nyman, W G Manning, S Samuels, and B F Morrey.
• Division of Health Services Research and Policy, University of Minnesota, Minneapolis 55455-0392, USA.
• Clin. Orthop. Relat. Res. 1998 May 1 (350): 257-67.

AbstractThis study investigates whether timely referral to specialists, in this case orthopaedic surgeons, potentially can reduce the costs of a health care episode. Five musculoskeletal diagnoses were chosen, and the diagnostic and treatment history of approximately 2500 persons with these five diagnoses was traced to determine when in the course of their treatment episode they were referred from nonorthopaedist to orthopaedist care and how much their episode of care cost. It was found that the average episodic costs for those who were referred earlier in the episode of care was lower than for those referred later. The implication is that there are likely to be numerous identifiable health conditions that should be flagged for early referral to specialists to reduce costs. It also questions the validity of the presumption that specialist care is necessarily more expensive.

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