了解儿童阑尾炎核磁共振成像的供应商成本：基于时间驱动活动的成本核算分析。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2024-10-01 DOI:10.1016/j.jacr.2024.05.008

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引用次数: 0

摘要

目的：采用基于时间驱动活动的成本计算（TDABC）方法，对快速磁共振成像阑尾炎检查与其他磁共振成像阑尾炎检查常用的当前程序技术（CPT）代码计费的提供商成本进行比较：将快速磁共振阑尾炎检查与不使用静脉注射造影剂的磁共振骨盆检查、不使用静脉注射造影剂的磁共振腹部/骨盆检查以及使用静脉注射造影剂的磁共振腹部/骨盆检查进行比较。通过直接观察患者的检查过程（20 人）和相关医护人员的反馈，绘制了每种检查的流程图。此外，还从 327 次核磁共振成像检查的电子病历中收集了其他数据。计算了人员、设备和设施的实际能力成本率。将能力成本率乘以每个步骤的平均持续时间，即可计算出每个步骤的成本。将每个步骤的成本相加，得出每次核磁共振成像检查的总成本：核磁共振成像检查类型的平均持续时间和费用如下：MRI 阑尾炎：11（范围：6-25）分钟，20.03 美元（7.80-44.24）；MRI 骨盆，无静脉注射造影剂：55（29-205）分钟，105.99 美元（64.18-285.13）；MRI 腹部/骨盆，无静脉注射造影剂：55（29-205）分钟，105.99 美元（64.18-285.13）。13）；不使用静脉造影剂的 MRI 腹部/骨盆：65（26-173）分钟，144.83 美元（61.16-196.50）；使用静脉造影剂的 MRI 腹部/骨盆：128（39-303）分钟，236.99 美元（102.62-556.54）：结论：提供快速阑尾炎 MRI 检查的估计成本明显低于使用阑尾炎 MRI 常用 CPT 代码计费的其他 MRI 检查。为了提高患者的成本效益，并使有限磁共振成像检查在儿科人群中得到更广泛的应用，需要建立适当的机制对有限序列的快速磁共振成像检查进行收费。

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Understanding Provider Cost of MRI for Appendicitis in Children: A Time-Driven Activity-Based Costing Analysis

Objective

To use time driven activity-based costing to characterize the provider cost of rapid MRI for appendicitis compared to other MRI examinations billed with the same Current Procedural Terminology codes commonly used for MRI appendicitis examinations.

Methods

Rapid MRI appendicitis examination was compared with MRI pelvis without intravenous contrast, MRI abdomen/pelvis without intravenous contrast, and MRI abdomen/pelvis with intravenous contrast. Process maps for each examination were created through direct shadowing of patient procedures (n = 20) and feedback from relevant health care professionals. Additional data were collected from the electronic medical record for 327 MRI examinations. Practical capacity cost rates were calculated for personnel, equipment, and facilities. The cost of each step was calculated by multiplying the capacity cost rate with the mean duration of each step. Stepwise costs were summed to generate a total cost for each MRI examination.

Results

The mean duration and costs for MRI examination type were as follows: MRI appendicitis: 11 (range: 6-25) min, $20.03 (7.80-44.24); MRI pelvis without intravenous contrast: 55 (29-205) min, $105.99 (64.18-285.13); MRI abdomen/pelvis without intravenous contrast: 65 (26-173) min, $144.83 (61.16-196.50); MRI abdomen/pelvis with intravenous contrast: 128 (39-303) min, $236.99 (102.62-556.54).

Conclusion

The estimated cost of providing a rapid appendicitis MRI examination is significantly less than other MRI examinations billed using Current Procedural Terminology codes typically used for appendicitis MRI. Mechanisms to appropriately bill rapid MRI examinations with limited sequences are needed to improve cost efficiency for the patient and to enable wider use of limited MRI examinations in the pediatric population.

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.