Enzmann D R, Anglada P M, Haviley C, Venta L A
Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Suite 800, Chicago, IL 60611, USA.
Radiology. 2001 May;219(2):467-73. doi: 10.1148/radiology.219.2.r01ma18467.
To perform a financial analysis of mammography services to determine whether the key underlying economic drivers of this service are aligned with the public's expectations.
The financial status of mammography services at seven university-based programs was assessed by using an extensive financial survey encompassing revenue, direct and indirect costs, and volume data for 1997 and 1998. At one of the institutions, an activity-based costing analysis was performed by procedure type: screening mammography, diagnostic mammography, breast ultrasonography, interventional procedures, and review of outside mammograms.
All seven institutions incurred losses in the professional component of mammography services. The underlying financial problem was a negative contribution margin (total mammography revenues minus direct expenses). The driver of the financial loss was the volume of diagnostic mammograms, which generated a loss per procedure. Diagnostic mammogram volume drove the mammography full-time equivalent count (P =.039) and was highly and negatively correlated with contribution margin (P <.001).
The reimbursement rate for mammography procedures, especially diagnostic mammography, needs to be increased to reflect the current reality of the resources necessary to maintain the accessibility and accuracy of this evolving mix of clinical services.
对乳腺钼靶检查服务进行财务分析，以确定该服务的关键潜在经济驱动因素是否符合公众期望。
通过一项广泛的财务调查评估了七个大学附属医院项目中乳腺钼靶检查服务的财务状况，该调查涵盖了1997年和1998年的收入、直接和间接成本以及工作量数据。在其中一个机构，按程序类型进行了作业成本分析：乳腺钼靶筛查、诊断性乳腺钼靶检查、乳腺超声检查、介入性操作以及外部乳腺钼靶片复查。
所有七个机构的乳腺钼靶检查服务专业部分均出现亏损。根本的财务问题是负边际贡献（乳腺钼靶检查总收入减去直接费用）。财务亏损的驱动因素是诊断性乳腺钼靶检查的工作量，每次检查都会产生亏损。诊断性乳腺钼靶检查的工作量推动了乳腺钼靶检查的全职等效工作量（P = 0.039），并且与边际贡献高度负相关（P < 0.001）。
需要提高乳腺钼靶检查程序，尤其是诊断性乳腺钼靶检查的报销率，以反映维持这种不断发展的临床服务组合的可及性和准确性所需资源的当前实际情况。
