{"title":"Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.","authors":"A L Lääperi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinatio","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"407 ","pages":"1-54"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19774216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J C Bouard, D Lyonnet, J P Illes, C Bouard-Monnier, O Rouviere, C Pangaud
{"title":"Clinical experience with iobitridol 250-300 in digital subtraction angiography. Double-blind randomized studies vs. iopromide and iohexol.","authors":"J C Bouard, D Lyonnet, J P Illes, C Bouard-Monnier, O Rouviere, C Pangaud","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Iobitridol was clinically tested in DSA against iopromide (i.v. DSA) or iohexol (i.a. DSA) in 139 patients. Seven patients participated in the i.v. DSA trial and 60 in the i.a. DSA study. Each examination was rated as diagnostic or not and the image quality was noted. Nature, onset, intensity and outcome of each adverse reaction were recorded. There was no significant difference in imaging quality and side effect occurrence between the 2 groups. We conclude that iobitridol is a safe and efficient contrast medium, which can be recommended for DSA examinations.</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"85-8"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A Dencausse, X Violas, H Feldman, P Havard, C Chambon
{"title":"Pharmacokinetic profile of iobitridol.","authors":"A Dencausse, X Violas, H Feldman, P Havard, C Chambon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Iobitridol (Xenetix) is a new triiodinated monomer, nonionic, low-osmolality contrast agent. Animal pharmacokinetic studies (rats, rabbits, dogs) and in vitro studies show that it is a marker of extracellular fluid, i.e. it is distributed in the interstitial space, it does not penetrate into cells, it does not cross the healthy blood-brain barrier (BBB), it does not bind to proteins, and it is eliminated by glomerular filtration without secretion or reabsorption. These characteristics determine its use as an urography and angiography contrast agent as well as the precautions necessary to be taken, which are classical for contrast agents of this classification, related to administration in pathophysiologic populations (patients with renal failure, pregnant women or nursing mothers, neonates, etc. )</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"25-34"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomical variations of the tympanic and mastoid portions of the facial nerve canal. A radioanatomical investigation.","authors":"P A Dimopoulos, C Muren, O Smedby, K Wadin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To obtain information on the morphology of the tympanic and mastoid portions of the facial nerve canal, and on the appearance of unusual vascular channels and anomalies such as dehiscences.</p><p><strong>Material and methods: </strong>One hundred and two temporal bone preparations were examined by conventional radiography to evaluate mastoid pneumatization. Of these, 73 were examined by high resolution CT in order to test the ability of the method to detect dehiscences in the bony wall of the tympanic portion of the canal and the accompanying channels along its mastoid portion. Subsequently produced plastic preparations were used to measure the length and width of these 2 portions of the facial canal.</p><p><strong>Results: </strong>Our study reports observations on the three-dimensional morphology of the canal in the plastic casts. The study shows variations in the course and dehiscences of the tympanic portion. Additional bony channels along the mastoid portion are described. These results supplement those in previous investigations.</p><p><strong>Conclusion: </strong>The measurement results agree with those of previous investigations. The course of the tympanic portion is S-shaped and has an impression on its upper surface. High resolution CT reproduces dehiscences of the bony canal in a percentage similar to that of microscopical methods and in relevant sites. Pneumatization does not influence the dimensions of the 2 portions.</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"403 ","pages":"49-59"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19645675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Safety and efficacy of Xenetix, a new iodinated contrast agent, in pediatric angiocardiography.","authors":"A M Rossignol, J R Lusson, A Chantepie, J Losay","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this work was to study the safety and efficacy of iobitridol 350 in pediatric angiocardiography compared to iopamidol 370.</p><p><strong>Material and methods: </strong>40 children participated in each test group. Each examination was rated as diagnostic or nondiagnostic and the image quality was noted. Nature,onset,intensity as well as outcome of each adverse reaction was reported.</p><p><strong>Results: </strong>There was no significant difference in either image quality or clinical safety between the 2 groups.</p><p><strong>Conclusion: </strong>Iobitridol is a safe and effective contrast agent for pediatric angiocardiography.</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"81-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intravascular contrast agents. Current problems and future solutions-- a review.","authors":"M A Bettman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Iobitridol 300 compared to iopromide 300--a double-blind randomized phase-III study of clinical tolerance in total body CT.","authors":"H M Hoogewoud, B Woessmer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>PURPOSE, MATERIAL AND METHODS: The clinical safety of iobitriodol 300 mg I/ml and iopromide 300 mg I/ml were compared in a randomized double blind phase-III study conducted on 60 patients undergoing abdominal CT for a variety of indications. Each examination was rated as diagnostic or nondiagnostic and the image quality was noted. Nature, onset, intensity as well as outcome of each adverse reaction were recorded.</p><p><strong>Results: </strong>There was no significant difference in imaging quality and side effects between the contrast media. In this study, both iobitridol and iopromide provided excellent image quality and a low rate of side effects.</p><p><strong>Conclusion: </strong>Iobitridol is a safe and effective nonionic contrast agent for contrast-enhanced body CT.</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"62-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of transarterial embolization in the management of cerebral arteriovenous malformations.","authors":"G Wikholm","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"404 ","pages":"1-25"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19738304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Radioanatomical detail of the human temporal bone in relation to pneumatization. A correlative radioanatomical investigation.","authors":"P A Dimopoulos","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"403 ","pages":"7-59"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19645676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D Meyer, M Petta, M H Fouchet, M Vadel, M Schaefer, M Dugast-Zrihen, M Guillemot
{"title":"Stabilization of the hydrophilic sphere of iobitridol, a new nonionic iodinated contrast agent.","authors":"D Meyer, M Petta, M H Fouchet, M Vadel, M Schaefer, M Dugast-Zrihen, M Guillemot","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The chemotoxicity of iodinated contrast agents is essentially related to the spatial accessibilty of lipophilic and polarizable iodine atoms. This accessibility was examined in iobitridol by HPLC and 1H- and 13C-NMR spectroscopy,taking into account both the static distribution of the hydrophilic groups around the triiodinated benzene ring and in particular the dynamic modulation of this distribution. The aim of this latter parameter is to prevent distortion of the hydrophilic sphere of nonionic agents when faced with a hydrophobic environment. Iobitridol is characterized by 2 tertiary carbamoyl substituents whose high rotation barriers (deltaG*353=27.6 kcal for E/Z-rotation and deltaG*345=17.3 kcal for syn/anti-rotation) stabilize the hydrophilic sphere. The 3rd dihydroxylated anilide substituent does not undergo SMILES rearrangement and provides iobitridol with its even hydrophilic distribution. Iobitridol presents remarkable chemical solubility (>140% m/v) and stability. The iobitridol molecule was specifically designed with the aim of stabilizing the hydrophilic sphere around the triiodinated benzene ring, therefore permanently masking access to the iodine atoms. This new concept represents a further step forward towards the synthesis of new iodinated contrast agents which should be totally inert vis-a-vis biological membranes and proteins.</p>","PeriodicalId":7159,"journal":{"name":"Acta radiologica. Supplementum","volume":"400 ","pages":"8-16"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19597827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}