Wolk R B
Department of Radiology, Metro-West Medical Center, Natick, MA 01760.
AJR Am J Roentgenol. 1992 Jun;158(6):1243-5. doi: 10.2214/ajr.158.6.1590115.
Two major impediments to an effective mammography program are inaccessibility and cost. This article itemizes the expenses associated with providing a mobile screening program accredited by the American College of Radiology (ACR) during a 3-year period. Mobile Diagnostics Inc. established a mobile mammography service in April 1987. A 36-ft (11-m) van is staffed by two registered technologists. The unit includes on-board processing and educational videotapes. Analysis of expenses for the years 1988, 1989, and 1990 does not include interpretation fees. A total of 3522 patients were examined in 1988, 4232 in 1989, and 5005 in 1990. Fixed operating expenses in 1988 were $70/examination and variable expenses were $13/examination, resulting in an average total cost per examination of $83. Fixed costs in 1989 were $63, variable costs were $15, and total costs were $78 per examination. Fixed costs in 1990 were $55, variable costs were $14, and total costs were $69 per examination. Many third parties, including Medicare, are contemplating a global screening fee in the $50-$60 range. An average payment of $55 would require examination of more than 6500 patients a year or 28 patients a day to break even. Our experience suggests that some form of subsidization may be necessary to sustain a mobile mammography service at those reimbursement levels.
有效开展乳房X光检查项目存在两大主要障碍，即难以获得检查服务和成本问题。本文详细列出了在三年期间提供经美国放射学会（ACR）认可的移动筛查项目所涉及的费用。移动诊断公司于1987年4月设立了一项移动乳房X光检查服务。一辆36英尺（11米）长的厢式货车配备了两名注册技术人员。该设备包括车载处理设备和教育录像带。对1988年、1989年和1990年费用的分析不包括解读费用。1988年共检查了3522名患者，1989年为4232名，1990年为5005名。1988年的固定运营费用为每次检查70美元，可变费用为每次检查13美元，每次检查的平均总成本为83美元。1989年的固定成本为63美元，可变成本为15美元，每次检查的总成本为78美元。1990年的固定成本为55美元，可变成本为14美元，每次检查的总成本为69美元。包括医疗保险在内的许多第三方正在考虑收取50至60美元的全球筛查费用。平均每次支付55美元，每年需要检查超过6500名患者或每天检查28名患者才能实现收支平衡。我们的经验表明，在那些报销水平下，可能需要某种形式的补贴才能维持移动乳房X光检查服务。
