Costs in today's radiology:aBC analysis of typical situations in the transitional period

• Main Author: Ronkainen, J. (Johanna)
• Format: Doctoral Thesis
• Language: English
• Published: University of Oulu 2007
• Subjects: bone biopsy; computed radiography; cost and cost analysis; interventional magnetic resonance imaging; laser therapy
• Online Access: http://urn.fi/urn:isbn:9789514284816; http://nbn-resolving.de/urn:isbn:9789514284816

Abstract The purpose of this study was to analyze the costs incurred during the transitional period when a radiology department is gradually digitalized and magnetic resonance imaging (MRI) is gaining ground as guidance for interventions. The specific aims were: to compare the costs of computed (CR) radiography with the costs of conventional radiography, to analyze the cost structures of procedures and the effects of procedure volumes in a multipurpose interventional MRI (IMRI) unit, to compare the costs of MRI and computed tomography (CT)-guided bone biopsies, and to compare the costs of MRI-guided laser ablation and surgery in the treatment of osteoid osteoma. 34 140 plain-film examinations were analyzed; 3/4 of them were CR and 1/4 conventional radiography. The costs of CR were 9% higher compared to conventional radiography, due to the higher capital cost. In the IMRI unit, 563 diagnostic MRI examinations, 89 MRI-guided interventions, and 39 MRI-guided neurosurgical operations were performed. The cost analyses of the alternative simulation models of IMRI usage showed that the volume of diagnostic imaging had an effect on the unit costs of these procedures. Volume was not such a deterministic factor in interventions due to the high material costs. The volume of the neurosurgical use of IMRI had a major effect on the costs of radiological procedures. The costs of 18 MRI-guided and 12 CT-guided bone biopsies were compared. The cost of MRI-guided biopsy was 2.55-fold compared to CT-guided biopsy, due to the longer procedure time and the expensive MRI-compatible instrumentation. The costs of 7 MRI-guided laser ablations and 6 surgical treatments of osteoid osteoma were compared. The cost of laser ablation was higher than the cost of excision of a superficial osteoid osteoma. The cost of excision of a deep osteoma with metallic fixation was considerably higher, due to the higher material, personnel, and ward costs. Laser ablation diminishes the need for sick days and the duration of restricted weight bearing. In conclusion, a higher cost of a new method should be anticipated. The use of a new method should be justified by other factors, such as better efficiency, accuracy, lack of radiation, or mini-invasiveness.