Annertz M, Wingstrand H, Strömqvist B, Holtås S
Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
Acta Radiol. 1996 May;37(3 Pt 1):373-80. doi: 10.1177/02841851960371P178.
To evaluate the effects on cost, and number of primary and supplementary neuroradiologic examinations, after introducing MR imaging as the primary modality in the evaluation of the lumbar spine.
Two 5-month periods were compared: period 1--before MR; and period 2--after introduction of a 2nd MR device. In period 1, patients were examined with myelography and/or CT after referral from specialists only, whereas in period 2 both specialists and general practitioners could refer patients for MR imaging. The direct cost (neuroradiologic methods and hospitalization) and indirect cost (sick-leave and estimated loss of production caused by the diagnostic procedure) were estimated.
In period 1, investigations were started in 75 patients (62 myelographies and 13 CT examinations); in period 2, in 227 patients (198 MR, 21 CT, and 8 myelographies). The estimated total cost increased from SEK 825,000 to 1,265,000 (53%), the cost per investigated patient decreasing from 11,000 to 5565 (50%), and the cost of preoperative investigation per operated patient decreasing from 8616 to 5563 (35%). The number of supplementary examinations was unchanged.
评估在将磁共振成像（MR）作为腰椎评估的主要方式后，对成本以及初次和补充性神经放射学检查数量的影响。
比较两个5个月的时间段：时间段1——引入MR之前；时间段2——引入第二台MR设备之后。在时间段1，仅在专科医生转诊后对患者进行脊髓造影和/或CT检查，而在时间段2，专科医生和全科医生均可将患者转诊进行MR成像检查。估算了直接成本（神经放射学检查方法和住院费用）和间接成本（病假以及诊断程序导致的估计生产损失）。
在时间段1，75例患者开始进行检查（62例脊髓造影和13例CT检查）；在时间段2，227例患者进行了检查（198例MR检查、21例CT检查和8例脊髓造影）。估计总成本从825,000瑞典克朗增加到1,265,000瑞典克朗（增加了53%），每位接受检查患者的成本从11,000瑞典克朗降至5565瑞典克朗（降低了50%），每位接受手术患者的术前检查成本从8616瑞典克朗降至5563瑞典克朗（降低了35%）。补充检查的数量未变。
