Evens R G, Jost R G, Evens R G
AJR Am J Roentgenol. 1985 Aug;145(2):393-8. doi: 10.2214/ajr.145.2.393.
Of the 72 clinical magnetic resonance imaging (MRI) installations operating in the United States in 1985, operations data were obtained from 47. The average annual technical operating cost of each unit is estimated at $841,500 when performing 2000 clinical procedures. Most costs are fixed and the annual cost varies slightly, between $800,000 and $882,000, with procedure volumes of 1000-3000 annually. The "typical" clinical MRI unit currently is examining 1500 patients and billing 1260 patients annually with a mean technical charge of $500. Of the procedures, 77% are neuroradiologic (head and spine). Radiologists are responsible for 93% of MRI procedures. The partial-pay/bad-debt revenue deduction is high (40%). With annual technical costs of about $820,000 and net technical revenues of $378,000, the typical unit is operating at an annual economic loss of about $440,000. An economic break-even point would be met with a charge of $1100 at the current procedure volume or a volume of 2700 procedures/year at the current charge. MRI units in outpatient locations study more patients, perform considerably more spinal examinations, and have higher charges. Compared with computed tomography at a comparable stage of development, MRI has less clinical demand, more outpatient locations, three to five times higher costs, and two-and-one-half times higher charges. To achieve economic viability with a technical charge of $500 or less, increased patient volume and third-party payer acceptance to reduce the partial-pay/bad-debt revenue factor will be required.
1985年美国有72台临床磁共振成像(MRI)设备投入使用,其中47台提供了运营数据。当每年进行2000例临床检查时,每台设备的年技术运营成本估计为841,500美元。大部分成本是固定的,年成本在800,000美元至882,000美元之间略有变化,每年检查量为1000 - 3000例。目前“典型”的临床MRI设备每年检查1500名患者,向1260名患者收费,平均技术收费为500美元。在这些检查中,77%是神经放射学检查(头部和脊柱)。放射科医生负责93%的MRI检查。部分付费/坏账收入扣除率很高(40%)。由于年技术成本约为820,000美元,净技术收入为378,000美元,典型设备每年的经济损失约为440,000美元。在当前检查量下,收费达到1100美元或在当前收费水平下每年检查量达到2700例时,可实现经济收支平衡。门诊场所的MRI设备检查的患者更多,进行的脊柱检查显著更多,收费也更高。与处于可比发展阶段的计算机断层扫描相比,MRI的临床需求较少,门诊场所更多,成本高出三到五倍,收费高出二点五倍。要在技术收费为500美元或更低的情况下实现经济可行性,需要增加患者数量并获得第三方付款人的认可,以降低部分付费/坏账收入因素。