University of Iowa Hospitals and Clinics, Department of Orthopedic Surgery and Rehabilitation, Iowa City, IA.
Washington University School of Medicine, Department of Orthopedic Surgery, Saint Louis, MO.
Iowa Orthop J. 2020;40(1):185-190.
Recent changes in healthcare have placed increased emphasis on price transparency, quality measures, and improving the patient experience. However, limited information is available for patient cost of obtaining a hip MRI and factors associated with cost variability. For a patient with femoroacetabular impingement (FAI), this study sought to report (1) the availability of pricing and quality information for a hip magnetic resonance imaging (MRI) in the state of Iowa, (2) the time investment required to obtain pricing and quality information, and (3) factors that influence hip MRI cost, quality and the time investment required for patients to obtain cost and quality information.
Within the state of Iowa, 126 unique hospital institutions and 30 active, private orthopaedic practices were identified. All 156 providers were contacted via telephone using a standardized script of a hypothetical 25-year-old adult male patient with FAI requesting a quote for a hip MRI. Cost of the MRI and its components, availability of payment discounts, and MRI magnet tesla (T) were requested. A final bundled cost (FBC) was calculated for each MRI provider with all available services and discounts applied. The total amount of time needed to obtain a quote from each location was recorded.
One hundred and thirty-six of the 156 institutions contacted provided hip MRI services (87%). Median call duration was 9.1 minutes (Range 2.3-25.6). Median FBC was $2,114.00 (Range $484.75-4,463.00) across all providers. Hospital median FBC was $2,261.70 (Range $909.62-4,463.00) versus $1,225.13 (Range $484.75-2,218.40) for independent imaging centers (P<0.0001). No difference in median cost was observed between nine available 3.0 T machines and eighty-nine 1.5 T machines (P=0.2655).
MRI cost varies widely across the state of Iowa and within individual metropolitan areas. Hip MRIs cost less at independent imaging centers compared to hospital locations. The amount of time required to obtain quality and cost data for a hip MRI presents a substantial time burden for patients with FAI. Surgeons, healthcare systems, and policy makers should be cognizant of the large price differences for a hip MRI and the time burden placed on patients with FAI to obtain this information..
最近医疗保健领域的变化更加注重价格透明度、质量措施和改善患者体验。然而，患者获得髋关节 MRI 的成本相关信息有限，成本变化的因素也有限。对于患有髋关节撞击症（FAI）的患者，本研究旨在报告：(1) 在爱荷华州，髋关节磁共振成像（MRI）的定价和质量信息的可获得性；(2) 获得定价和质量信息所需的时间投入；以及 (3) 影响髋关节 MRI 成本、质量以及患者获取成本和质量信息所需时间投入的因素。
在爱荷华州内，确定了 126 家独特的医院机构和 30 家活跃的私人骨科诊所。使用标准化脚本，对所有 156 名提供者进行了电话联系，假设一位 25 岁的男性 FAI 患者要求提供髋关节 MRI 的报价。请求了 MRI 的成本及其组成部分、支付折扣的可用性以及 MRI 磁体特斯拉 (T)。对每位 MRI 提供商的所有可用服务和折扣进行应用后，计算出最终捆绑成本 (FBC)。记录从每个地点获得报价所需的总时间。
156 家联系的机构中有 136 家（87%）提供髋关节 MRI 服务。平均通话时长为 9.1 分钟（范围为 2.3-25.6）。所有提供者的平均 FBC 为 2,114.00 美元（范围为 484.75-4,463.00）。医院的平均 FBC 为 2,261.70 美元（范围为 909.62-4,463.00），而独立影像中心的平均 FBC 为 1,225.13 美元（范围为 484.75-2,218.40）（P<0.0001）。在 9 台可用的 3.0 T 机器和 89 台 1.5 T 机器之间，中位成本没有差异（P=0.2655）。
爱荷华州内的髋关节 MRI 成本差异很大，在个别大都市区内也是如此。与医院相比，独立影像中心的髋关节 MRI 成本较低。获取髋关节 MRI 的质量和成本数据所需的时间对患有 FAI 的患者来说是一个巨大的时间负担。外科医生、医疗保健系统和政策制定者应该意识到髋关节 MRI 的巨大价格差异以及患者获取这些信息所带来的时间负担。
