Administrating oral contrasts to patients with nontraumatic abdominal pain in the emergency department (ED) amounted to more than $85,000 annually, according to authors of a single-institution study published in the Journal of the American College of Radiology.
There is ongoing debate over the use of oral contrasts in those with abdominopelvic pathologies, particularly in patients with a body mass index of more than 25 kg/m2, wrote lead author Prasad R. Shankar, MD, and colleagues.
“As national healthcare costs continue to rise, there is a growing focus on empirically evaluating these costs to assess the quality and value of care delivered,” authors added.
Researchers applied time-driven activity-based costing (TDABC) methods to both prospective time studies and retrospective data taken from a quaternary care center. The final cohort resulted in 5,263 radiology reports consisting of 4,434 individual patients. Two contrasts—barium sulfate suspension and diatrizoate meglumine-sodium contrast—were used during the study period.
Shankar and colleagues found the annual base case monetary cost associated with routine oral contrast administration in the ED prior to abdominopelvic CT for abdominal pain to be $82,552. After looking at proprietary internal data, the team noted their annual institutional cost was $68,780.
The single greatest influencer of total costs proved to be the volume of patients receiving contrast (86 percent utilization).
“Costs associated with oral contrast in the ED are modest and should be balanced with its potential diagnostic benefits,” Shankar et al. wrote.
The Michigan-based researchers also applied a new oral contrast policy change which stated contrasts were no longer required in patients with: body mass index less than 25 kg/m2, those with a history of surgery within 30 days and patients with a history of inflammatory bowel disease.
Analysis incorporating the new policy cut contrast costs by 52 percent, resulting in nearly $36,000 in savings.
“Oral contrast administration in the ED before abdominopelvic CT for non-traumatic abdominal pain is associated with directly attributable monetary costs and time costs that in general were less than have been observed in non-TDABC studies,” Shankar and colleagues concluded. “The cost analyses described in this investigation may be beneficial in providing a cost basis for future works.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.