Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial
Objectives To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen. Methods Altogether 300 patients with acute abdominal pain were randomised to computed tomography...
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| Veröffentlicht in: | European radiology 2013-09, Vol.23 (9), p.2538-2545 |
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| creator | Lehtimäki, Tiina Juvonen, Petri Valtonen, Hannu Miettinen, Pekka Paajanen, Hannu Vanninen, Ritva |
| description | Objectives
To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
Methods
Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT,
n
= 150) or selective imaging practice (SIP,
n
= 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
Results
Total treatment cost per patient was 1,202 euros (€) higher in the CT group compared to the SIP group (
P
= 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days,
P
= 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
Conclusion
Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.
Key Points
•
CT is widely used almost routinely in the diagnostics of acute abdomen
.
•
Patients with acute abdomen were randomised to routine CT or selective imaging
.
•
The treatment costs were significantly higher in the routine CT group
.
•
Length of hospital stay was longer in the CT group
.
•
Selective use of imaging may help control continuous increases of treatment costs
. |
| doi_str_mv | 10.1007/s00330-013-2848-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1419344727</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1419344727</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-cdd0015c7f0b63dc4d361060274b5e99e62cea797e4745f85845851662c78eaf3</originalsourceid><addsrcrecordid>eNp1kc-KFDEQxoMo7rj6AF4k4MVL1sqf7qSPMqy6sCDIeg6ZdLWTpTtpkzTie_jAZphVRPBUUPX7vqriI-QlhysOoN8WACmBAZdMGGWYekR2XEnBOBj1mOxgkIbpYVAX5Fkp9wAwcKWfkgshNe-05jvy82ZZna80TTSnrYaI1KdYsyuVYTy66HGk-zuaYuuXWqiLI90KngTHVNZQ3UwzlrRlj4WGSFdXA8ZGfg_1SJ3fKlJ3GNOC8Yp-xrLNbdbUjubmlZZQ2gY_hxh8s6o5uPk5eTK5ueCLh3pJvry_vtt_ZLefPtzs390yL7WozI8jAO-8nuDQy9GrUfYcehBaHTocBuyFR6cHjUqrbjKdUZ3peN_a2qCb5CV5c_Zdc_q2Yam2XeNxnl3EtBXLFR-kUlrohr7-B71vL8d23YkyvVB64I3iZ8rnVErGya45LC7_sBzsKTJ7jsy2yOwpMqua5tWD83ZYcPyj-J1RA8QZKG0Uv2L-a_V_XX8BpaKiDA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1418624791</pqid></control><display><type>article</type><title>Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Lehtimäki, Tiina ; Juvonen, Petri ; Valtonen, Hannu ; Miettinen, Pekka ; Paajanen, Hannu ; Vanninen, Ritva</creator><creatorcontrib>Lehtimäki, Tiina ; Juvonen, Petri ; Valtonen, Hannu ; Miettinen, Pekka ; Paajanen, Hannu ; Vanninen, Ritva</creatorcontrib><description>Objectives
To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
Methods
Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT,
n
= 150) or selective imaging practice (SIP,
n
= 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
Results
Total treatment cost per patient was 1,202 euros (€) higher in the CT group compared to the SIP group (
P
= 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days,
P
= 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
Conclusion
Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.
Key Points
•
CT is widely used almost routinely in the diagnostics of acute abdomen
.
•
Patients with acute abdomen were randomised to routine CT or selective imaging
.
•
The treatment costs were significantly higher in the routine CT group
.
•
Length of hospital stay was longer in the CT group
.
•
Selective use of imaging may help control continuous increases of treatment costs
.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-013-2848-4</identifier><identifier>PMID: 23715771</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdomen ; Abdomen, Acute - diagnostic imaging ; Abdomen, Acute - economics ; Adult ; Aged ; Appendicitis ; Clinical medicine ; Clinical trials ; Contrast Media - chemistry ; Cost-Benefit Analysis ; Costs ; Diagnostic Imaging - economics ; Diagnostic Radiology ; Emergency medical care ; Emergency Medicine - economics ; Female ; Finland ; Health Care Costs ; Health Economy ; Hospitals ; Humans ; Imaging ; Informed consent ; Internal Medicine ; Interventional Radiology ; Length of Stay ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Models, Economic ; Neuroradiology ; Pain ; Patient admissions ; Patient Discharge ; Prospective Studies ; Radiology ; Surgeons ; Surgery ; Tomography ; Tomography, X-Ray Computed - economics ; Ultrasound</subject><ispartof>European radiology, 2013-09, Vol.23 (9), p.2538-2545</ispartof><rights>European Society of Radiology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-cdd0015c7f0b63dc4d361060274b5e99e62cea797e4745f85845851662c78eaf3</citedby><cites>FETCH-LOGICAL-c372t-cdd0015c7f0b63dc4d361060274b5e99e62cea797e4745f85845851662c78eaf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-013-2848-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-013-2848-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23715771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lehtimäki, Tiina</creatorcontrib><creatorcontrib>Juvonen, Petri</creatorcontrib><creatorcontrib>Valtonen, Hannu</creatorcontrib><creatorcontrib>Miettinen, Pekka</creatorcontrib><creatorcontrib>Paajanen, Hannu</creatorcontrib><creatorcontrib>Vanninen, Ritva</creatorcontrib><title>Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
Methods
Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT,
n
= 150) or selective imaging practice (SIP,
n
= 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
Results
Total treatment cost per patient was 1,202 euros (€) higher in the CT group compared to the SIP group (
P
= 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days,
P
= 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
Conclusion
Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.
Key Points
•
CT is widely used almost routinely in the diagnostics of acute abdomen
.
•
Patients with acute abdomen were randomised to routine CT or selective imaging
.
•
The treatment costs were significantly higher in the routine CT group
.
•
Length of hospital stay was longer in the CT group
.
•
Selective use of imaging may help control continuous increases of treatment costs
.</description><subject>Abdomen</subject><subject>Abdomen, Acute - diagnostic imaging</subject><subject>Abdomen, Acute - economics</subject><subject>Adult</subject><subject>Aged</subject><subject>Appendicitis</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Contrast Media - chemistry</subject><subject>Cost-Benefit Analysis</subject><subject>Costs</subject><subject>Diagnostic Imaging - economics</subject><subject>Diagnostic Radiology</subject><subject>Emergency medical care</subject><subject>Emergency Medicine - economics</subject><subject>Female</subject><subject>Finland</subject><subject>Health Care Costs</subject><subject>Health Economy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Imaging</subject><subject>Informed consent</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Models, Economic</subject><subject>Neuroradiology</subject><subject>Pain</subject><subject>Patient admissions</subject><subject>Patient Discharge</subject><subject>Prospective Studies</subject><subject>Radiology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - economics</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc-KFDEQxoMo7rj6AF4k4MVL1sqf7qSPMqy6sCDIeg6ZdLWTpTtpkzTie_jAZphVRPBUUPX7vqriI-QlhysOoN8WACmBAZdMGGWYekR2XEnBOBj1mOxgkIbpYVAX5Fkp9wAwcKWfkgshNe-05jvy82ZZna80TTSnrYaI1KdYsyuVYTy66HGk-zuaYuuXWqiLI90KngTHVNZQ3UwzlrRlj4WGSFdXA8ZGfg_1SJ3fKlJ3GNOC8Yp-xrLNbdbUjubmlZZQ2gY_hxh8s6o5uPk5eTK5ueCLh3pJvry_vtt_ZLefPtzs390yL7WozI8jAO-8nuDQy9GrUfYcehBaHTocBuyFR6cHjUqrbjKdUZ3peN_a2qCb5CV5c_Zdc_q2Yam2XeNxnl3EtBXLFR-kUlrohr7-B71vL8d23YkyvVB64I3iZ8rnVErGya45LC7_sBzsKTJ7jsy2yOwpMqua5tWD83ZYcPyj-J1RA8QZKG0Uv2L-a_V_XX8BpaKiDA</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Lehtimäki, Tiina</creator><creator>Juvonen, Petri</creator><creator>Valtonen, Hannu</creator><creator>Miettinen, Pekka</creator><creator>Paajanen, Hannu</creator><creator>Vanninen, Ritva</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial</title><author>Lehtimäki, Tiina ; Juvonen, Petri ; Valtonen, Hannu ; Miettinen, Pekka ; Paajanen, Hannu ; Vanninen, Ritva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-cdd0015c7f0b63dc4d361060274b5e99e62cea797e4745f85845851662c78eaf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdomen</topic><topic>Abdomen, Acute - diagnostic imaging</topic><topic>Abdomen, Acute - economics</topic><topic>Adult</topic><topic>Aged</topic><topic>Appendicitis</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Contrast Media - chemistry</topic><topic>Cost-Benefit Analysis</topic><topic>Costs</topic><topic>Diagnostic Imaging - economics</topic><topic>Diagnostic Radiology</topic><topic>Emergency medical care</topic><topic>Emergency Medicine - economics</topic><topic>Female</topic><topic>Finland</topic><topic>Health Care Costs</topic><topic>Health Economy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Imaging</topic><topic>Informed consent</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Models, Economic</topic><topic>Neuroradiology</topic><topic>Pain</topic><topic>Patient admissions</topic><topic>Patient Discharge</topic><topic>Prospective Studies</topic><topic>Radiology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - economics</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lehtimäki, Tiina</creatorcontrib><creatorcontrib>Juvonen, Petri</creatorcontrib><creatorcontrib>Valtonen, Hannu</creatorcontrib><creatorcontrib>Miettinen, Pekka</creatorcontrib><creatorcontrib>Paajanen, Hannu</creatorcontrib><creatorcontrib>Vanninen, Ritva</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lehtimäki, Tiina</au><au>Juvonen, Petri</au><au>Valtonen, Hannu</au><au>Miettinen, Pekka</au><au>Paajanen, Hannu</au><au>Vanninen, Ritva</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>23</volume><issue>9</issue><spage>2538</spage><epage>2545</epage><pages>2538-2545</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
Methods
Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT,
n
= 150) or selective imaging practice (SIP,
n
= 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
Results
Total treatment cost per patient was 1,202 euros (€) higher in the CT group compared to the SIP group (
P
= 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days,
P
= 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
Conclusion
Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.
Key Points
•
CT is widely used almost routinely in the diagnostics of acute abdomen
.
•
Patients with acute abdomen were randomised to routine CT or selective imaging
.
•
The treatment costs were significantly higher in the routine CT group
.
•
Length of hospital stay was longer in the CT group
.
•
Selective use of imaging may help control continuous increases of treatment costs
.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23715771</pmid><doi>10.1007/s00330-013-2848-4</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2013-09, Vol.23 (9), p.2538-2545 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1419344727 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Abdomen Abdomen, Acute - diagnostic imaging Abdomen, Acute - economics Adult Aged Appendicitis Clinical medicine Clinical trials Contrast Media - chemistry Cost-Benefit Analysis Costs Diagnostic Imaging - economics Diagnostic Radiology Emergency medical care Emergency Medicine - economics Female Finland Health Care Costs Health Economy Hospitals Humans Imaging Informed consent Internal Medicine Interventional Radiology Length of Stay Male Medical imaging Medicine Medicine & Public Health Middle Aged Models, Economic Neuroradiology Pain Patient admissions Patient Discharge Prospective Studies Radiology Surgeons Surgery Tomography Tomography, X-Ray Computed - economics Ultrasound |
| title | Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial |
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