Changing patterns in the evaluation of renal masses: economic implications

This study compares the cost of evaluating renal masses at the Mayo Clinic before and after the use of sonography and computed tomography gained clinical acceptance. Two hundred two adult patients discovered to have renal masses in 1973 were compared with 204 patients discovered to have renal masses in 1980. After adjustment for inflation and differences in the frequency of the various diagnoses, the average cost of evaluating patients in 1980 was 30% less than the cost in 1973; this difference is statistically significant (p = 0.024). The reduction in cost is attributable primarily to a 77% decrease in the use of angiography. The largest reduction in cost occurred in the evaluation of malignant lesions. The study demonstrates that the clinical use of new imaging methods in the evaluation of renal masses can be associated with decreased costs for the patient.