Nuclear Medicine Division, Mont-Godinne Medical Center, Université Catholique de Louvain, Mont-Godinne, Belgium.
Health Policy. 2009 Oct;92(2-3):234-43. doi: 10.1016/j.healthpol.2009.04.002. Epub 2009 May 14.
The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes.
The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose.
The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%).
The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.
本研究旨在通过定义构成成分并模拟可能的资源或实践变化的影响，使用作业成本法更深入地了解正电子发射断层扫描程序（FDG-PET）的实际成本结构。
成本数据来自医院管理部门、人员和供应商访谈以及结构化问卷。流程图将流程分为 16 项与患者和非患者相关的活动，详细的成本数据与这些活动相关联。单因素敏感性分析显示，不同参数对单个成本的影响程度，并评估可能的资源或实践变化（如购买混合 PET/CT 设备、患者吞吐量或 370MBq（18）F-FDG 患者剂量的销售价格）的影响。
PET 中心将 73%的时间用于临床活动，注射示踪剂后的休息时间（42%）是单个最大的部门成本要素。示踪剂成本和运营时间对每个程序的成本影响最大。分析显示，FDG-PET 的总成本范围为 BGO PET 相机的 859 欧元到 16 层 PET-CT 系统的 1142 欧元，资源成本的分布顺序递减：材料（44%）、设备（24%）、工资（16%）、空间（6%）和医院间接费用（10%）。
FDG-PET 的成本主要受放射性药物成本的影响。因此，为了提高其成本效益，应减少后者而不是运营时间。
