Stacul F, Pozzi-Mucelli F, Lubin E, Gava S, Cuttin-Zernich R, Grisi G, Cova M A
Unità Clinica Operativa di Radiologia, Università degli Studi di Trieste, Ospedale di Cattinara, Strada di Fiume 447, I1-34149 Trieste, Italy.
Radiol Med. 2006 Feb;111(1):73-84. doi: 10.1007/s11547-006-0008-5.
The aim of this study was to analyse the costs pertaining to the radiology department of magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) in the evaluation of arterial disease of the lower limbs.
The differential cost of the two procedures, i.e. the sum of equipment costs (amortisation and service contract), variable costs (supplies and related services) and personnel costs (radiologist, radiographer and nurse) was determined. The common cost (auxiliary personnel and indirect internal costs) was also calculated. Finally, the full cost of the two procedures was obtained (sum of differential and common costs).
The differential cost of MRA was 186.14 euro (equipment costs: 50.80 euro, variable costs: 75.04 euro, personnel costs: 60.30 euro) while the differential cost of intra-arterial DSA was 238.18 euro (equipment costs: 57.60 euro, variable costs: 90.13 euro, staff costs: 90.45 euro). The estimated common cost was 5.62 euro. Therefore, the full cost of MRA was 191.76 euro and the full cost of intra-arterial DSA was 243.80 euro (27.1% higher).
Intra-arterial DSA costs more than MRA, mainly because of the higher costs of supplies used during the procedure and higher personnel costs (as a result of the longer duration of intra-arterial DSA). It should be noted that our evaluation considers costs pertaining to the radiology department only. It is evident that an economic analysis considering hospital costs as well would result in much higher costs for DSA if post-procedure hospitalisation is required. Our results cannot be simply exported to other radiology departments since they refer to the technology and organisation adopted in our department. However, our cost analysis model can be easily applied to other environments. MRA provides good diagnostic accuracy in the evaluation of arteries of the lower extremities, and its biological cost is far lower than that of intra-arterial DSA (MRA is noninvasive, it does not use ionising radiation, and the contrast medium is safe). Its lower cost is another argument in favour of the use of MRA instead of intra-arterial DSA in the evaluation of lower-extremity arterial disease.
本研究旨在分析在评估下肢动脉疾病时，磁共振血管造影（MRA）和动脉内数字减影血管造影（DSA）在放射科的相关成本。
确定了这两种检查方法的差异成本，即设备成本（折旧和服务合同）、可变成本（耗材和相关服务）以及人员成本（放射科医生、放射技师和护士）之和。还计算了共同成本（辅助人员和间接内部成本）。最后，得出这两种检查方法的总成本（差异成本与共同成本之和）。
MRA的差异成本为186.14欧元（设备成本：50.80欧元，可变成本：75.04欧元，人员成本：60.30欧元），而动脉内DSA的差异成本为238.18欧元（设备成本：57.60欧元，可变成本：90.13欧元，人员成本：90.45欧元）。估计的共同成本为5.62欧元。因此，MRA的总成本为191.76欧元，动脉内DSA的总成本为243.80欧元（高出27.1%）。
动脉内DSA的成本高于MRA，主要是因为检查过程中使用的耗材成本较高以及人员成本较高（由于动脉内DSA持续时间更长）。应当指出，我们的评估仅考虑了放射科的成本。显然，如果需要术后住院治疗，将医院成本也考虑在内的经济分析会使DSA的成本高得多。我们的结果不能简单地推广到其他放射科，因为它们是针对我们科室所采用的技术和组织情况。然而，我们的成本分析模型可以很容易地应用于其他环境。MRA在评估下肢动脉方面具有良好的诊断准确性，并且其生物学成本远低于动脉内DSA（MRA是非侵入性的，不使用电离辐射，并且造影剂是安全的）。其较低的成本是在评估下肢动脉疾病时支持使用MRA而非动脉内DSA的另一个理由。
