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Comparison of US Utilization and Technical Costs before and after Establishment of 24-hour In-house Coverage for US Examinations¹

¹ From the Department of Radiology (J.P.M., M.S.C., C.D.J.) and Division of Emergency Medicine (J.R.R.), University of California-Davis Medical Center, Ambulatory Care Center, 4860 Y St, Ste 3100, Sacramento, CA 95817. From the 1998 RSNA scientific assembly. Received May 27, 1999; revision requested August 5; final revision received March 3, 2000; accepted March 7. Address correspondence to J.P.M. (e-mail: john.mcgahan@ucdmc.ucdavis.edu).

PURPOSE: To compare data regarding the cost and number of ultrasonographic (US) examinations performed for 6 months, before and after institution of 24-hour in-house sonographer coverage.

MATERIALS AND METHODS: Data for a 6-month period during which US services were provided by a sonographer on call from 11 PM to 7 AM were compared with data for a 6-month period during which a sonographer was in house during this shift.

RESULTS: With 11 PM to 7 AM on-call coverage, the sonographers performed 147 examinations in a 6-month period, an average of 0.81 examination per shift. After institution of in-house coverage for this shift, 792 US examinations were performed in 6 months, an average of 4.3 examinations per shift. The cost for 11 PM to 7 AM in-house sonographer coverage for 6 months was approximately $16,000 more than that for on-call coverage. This cost would be offset by revenues from one additional examination per night. The cost per examination for the 11 PM to 7 AM shift decreased from $124.70 to $43.33.

CONCLUSION: At the authors’ institution, 24-hour in-house sonographer coverage resulted in additional cost, which was offset by revenues from additional examinations. There was nearly a fivefold increase in the number of US examinations performed per shift. These examinations were performed more expediently, enabling more rapid patient triage.

Index terms: Cost-effectiveness • Emergency medical service system • Radiology and radiologists, departmental management • Ultrasound (US), utilization

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