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Health Policy and Practice |
1 From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 32 Fruit St, Boston, MA 02114. From the 1998 RSNA scientific assembly. Received March 3, 2000; revision requested April 24; revision received June 16; accepted July 11. Supported in part by GE Medical Systems. Address correspondence to S.S. (e-mail: saini.sanjay@mgh.harvard.edu).
PURPOSE: To measure the technical cost of different categories of computed tomographic (CT) examinations.
MATERIALS AND METHODS: For fiscal year 1997, the technical costs of performing CT examinations in a tertiary care academic medical center were measured. Costs were divided into labor and nonlabor categories. Indirect departmental costs were fully allocated according to activity-based methods. Hospital overhead costs were set at 85% of the departmental budget. Physician costs, including those related to image interpretation were not included. The technical cost of CT was determined on a per technical relative value unit (RVU) basis and on a per examination basis. For the latter, the technical cost of nonenhanced CT, contrast material–enhanced diagnostic CT, and interventional CT procedures were determined.
RESULTS: In fiscal year 1997, 45,599 examinations (22,158 [48.6%] abdominal and/or pelvic, 12,115 [26.6%] head and neck, 6,572 [14.4%] thoracic, 1,593 [3.5%] interventional, and 3,161 [6.9%] other) were performed with five CT scanners for a technical RVU output of 254,461. Of 45,599 examinations, 31,007 (68%) were performed with intravenously administered contrast medium. Overall labor costs were $1,744,653, and nonlabor costs were $2,912,282. The cost of a hypothetical CT examination with a mean technical RVU of 5.58 was $189. The overall cost per examination was $150 for nonenhanced CT, $237 for contrast-enhanced CT, and $462 for interventional CT.
CONCLUSION: Although CT is based on sophisticated technology, the mean technical cost of a diagnostic CT examination is less than $200.
Index terms: Computed tomography (CT), utilization • Cost-effectiveness • Economics, medical • Radiology and radiologists, socioeconomic issues
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