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[德国一家大学医院头颅对比增强磁共振成像的成本分析]

[Cost analysis of contrast-enhanced cranial MRI at a German university hospital].

作者信息

Schreyer A G, Friedrich C, Mrosek S, Hoffstetter P, Rennert J, Framme C, Jung E M, Feuerbach S, Schöffski O, Zorger N

机构信息

Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg.

出版信息

Rofo. 2010 Oct;182(10):891-9. doi: 10.1055/s-0029-1245511. Epub 2010 Jun 18.

Abstract

PURPOSE

Detailed evaluation and cost analysis of a cranial contrast-enhanced MRI (c-ceMRI) in outpatients, inpatients, patients in an intensive care unit and children under anesthesia.

MATERIALS AND METHODS

Based on a detailed process-oriented model, we calculated the cost of a cranial MRI for the four situations mentioned above. A comprehensive evaluation of the overhead and personnel costs was performed.

RESULTS

We performed 5108 MRI examinations on 2 scanners in the year 2008. 2150 examinations (42 %) were identified as c-ceMRI. For inpatients we calculated a total cost of € 242.46 per examination with a personnel cost of € 81.71 for the radiological department. In outpatients we calculated total costs of € 181.97 with radiological personnel costs of € 68.67. Patients coming from an intensive care unit were treated by an intensive care team, which resulted in total costs of € 416.58 with € 283 in costs for radiological personnel (32.8 %). MRI examinations of children under anesthesia resulted in costs of € 616.79 for the hospital, of which € 285.78 were radiological personnel costs (34.5 %).

CONCLUSION

In this study we evaluated for the first time different radiological scenarios of a c-ceMRI at a university hospital. Considering the present reimbursement situation, all outpatients covered by statutory health insurance resulted in a deficit for the hospital. Particularly high costs for patients in intensive care units as well as for children under anesthesia have to be taken into account and are currently not adequately covered by care providers.

摘要

目的

对门诊患者、住院患者、重症监护病房患者及麻醉下儿童进行头颅对比增强磁共振成像(c-ceMRI)的详细评估及成本分析。

材料与方法

基于详细的面向流程模型,我们计算了上述四种情况下头颅磁共振成像的成本。对间接费用和人员成本进行了全面评估。

结果

2008年我们使用两台扫描仪进行了5108次磁共振成像检查。其中2150次检查(42%)被确定为c-ceMRI。对于住院患者,我们计算出每次检查的总成本为242.46欧元,放射科的人员成本为81.71欧元。对于门诊患者,我们计算出总成本为181.97欧元,放射科人员成本为68.67欧元。来自重症监护病房的患者由重症监护团队治疗,这导致总成本为416.58欧元,其中放射科人员成本为283欧元(32.8%)。麻醉下儿童的磁共振成像检查使医院成本达到616.79欧元,其中放射科人员成本为285.78欧元(34.5%)。

结论

在本研究中,我们首次在大学医院评估了c-ceMRI的不同放射学情况。考虑到目前的报销情况,所有法定医疗保险覆盖的门诊患者都会给医院带来亏损。必须考虑到重症监护病房患者以及麻醉下儿童的成本特别高,而目前护理提供者对此覆盖不足。

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