Evens R G, Evens R G
Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110.
AJR Am J Roentgenol. 1991 Sep;157(3):603-7. doi: 10.2214/ajr.157.3.1872246.
Personnel from the 72 facilities with the most experience in MR imaging were surveyed, and 45 questionnaires were returned with data to study the economics and use of MR imaging facilities. The data from 1990 were compared with results of studies done in 1985 and 1987. The facilities studied were highly selected, and the data and conclusions are unlikely to be representative of all MR facilities currently operational in the United States. The "typical" MR unit operated about 66 hr per week and imaged 68 patients. Most procedures were examinations of the head and spine (73%), with examinations of bone and joint increasing in frequency (17%). Scheduling delays for both inpatients and outpatients have decreased since 1987, indicating that clinical demand is being met by MR facilities. The global (technical plus professional) charge for an examination was approximately $950, and the charge for IV contrast material was an additional $200. IV contrast material was used in approximately 40% of head and 20% of spine studies. The typical MR units in 1990 was used to examine more than 3000 patients per year at a charge of approximately $750 each for the technical component. Technical billings for each unit were approximately $2.3 million, and net revenues were almost $1.9 million. We estimate the annual operating cost of an MR unit in 1990 was $1.3 million, so the typical MR unit had an annual net profit of approximately $500,000. This is a considerable improvement from the economic position in 1985, when each MR unit was losing approximately $400,000 annually. We conclude that experienced MR imaging facilities are now profitable owing to increased efficiency and continually rising charges. We suggest the economic historical pattern demonstrated by MR imaging (large losses initially followed by profitability within several years owing to increased efficiency and higher charges) is a typical pattern for many new technologies with the current medical payment system in the United States.
对72家在磁共振成像方面经验最为丰富的机构的工作人员进行了调查，共收回45份附有数据的问卷，用于研究磁共振成像设备的经济性和使用情况。将1990年的数据与1985年和1987年所做研究的结果进行了比较。所研究的机构是经过高度挑选的，因此这些数据和结论不太可能代表目前在美国运营的所有磁共振设备。“典型的”磁共振设备每周运行约66小时，为68名患者进行成像。大多数检查是头部和脊柱检查（73%），骨与关节检查的频率在增加（17%）。自1987年以来，住院患者和门诊患者的检查安排延误均有所减少，这表明磁共振设备能够满足临床需求。一次检查的总（技术加专业）费用约为950美元，静脉造影剂的费用额外再加200美元。约40%的头部检查和20%的脊柱检查使用了静脉造影剂。1990年典型的磁共振设备每年用于检查超过3000名患者，技术部分每项收费约750美元。每个设备的技术计费约为230万美元，净收入近190万美元。我们估计1990年一台磁共振设备的年度运营成本为130万美元，因此典型的磁共振设备年净利润约为50万美元。与1985年的经济状况相比，这有了相当大的改善，当时每个磁共振设备每年亏损约40万美元。我们得出结论，由于效率提高和收费不断上涨，经验丰富的磁共振成像机构现在实现了盈利。我们认为，磁共振成像所展示的经济历史模式（最初巨额亏损，随后由于效率提高和收费上涨在几年内实现盈利）是美国当前医疗支付系统下许多新技术的典型模式。
