Baffert S, Fay AF, Kalifa G, Tubiana JM, Lanoe JL, Fery-Lemonnier E; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 41.

Committee for Evaluation and Diffusion of Innovative Technologies (CEDIT), AP-HP, Paris, France.

OBJECTIVE: French regulation of CT scanners (1/100,000 inhabitants) led radiologists to choose high-end CT scanners. But other CT scanners that are proposed at lower purchase price are becoming technically more efficient. In view of a possible easing of constraints concerning new equipment, and as our literature review revealed no study comparing low-end to high-end CT scanners in technical, medical or economic terms, we studied the possibility of using low-end CT scanners in the technical setting of 50 hospitals of Paris area regional university hospital group: the Assistance Publique- Hospitaux de Paris (AP-HP). METHODS: In this presentation, we will focus on the economic aspects. Operating costs are as follows: 1)Fixed costs include equipment acquisition, installation, and financial (depreciation and interest) costs; 2)Variable costs include maintenance, replacement of X-ray tubes, medical and non-medical staff, radiology supplies and management expenses. Data were collected in seven AP-HP hospitals over a 12-month period. RESULTS: The annual operating costs of low-end CT scanners were $474,666 vs. $619,666 for high-end scanners (at a minimum activity level of 4,500 examinations required by the national health insurance for low-end CT scan reimbursement). Our analysis led to the following results: 1)Fixed costs are on average 17% of the total cost in the case of low-end CT scanners and 18% in the case of high-end CT scanners. For both types of equipment, fixed costs are revealed to be a lower proportion of the total investment than expected; 2) The relative weight of maintenance and replacement of X-ray tubes is constant whatever the activity level: 18% for low-end vs. 26% for high-end CT scanners. Maintenance contracts are on a sliding scale, above a given basic level of activity. 3)Personnel (medical and non-medical) represents the larger part of total costs: 40% for low-end vs. 32% for high-end CT scanners. 4)Expendature for radiology supplies and management expenses are practically the same for both low-end and high-end CT scanners (25% and 24%). The real advantage to installing low-end CT scanners would be to relieve the existing high-end CT scanners of part of their excess work load. The number of scans will undoubtable rise leading to reduced unit costs. Indeed, low-end CT scanners are profitable only when used in addition to the high-end CT scanners; the higher the activity level, the more worthwhile the low-end CT scanner. CONCLUSIONS: The recommendation is that low-end scanners not be used until their medical and technical assessment has been completed. Future recommendations will be based upon the results of this medical and technical study as well as on our economic analysis.

Publication Types:

• Meeting Abstracts

Keywords:

• Costs and Cost Analysis
• Health Expenditures
• Hospitals
• Hospitals, Public
• Paris
• Radiology
• Radiology Information Systems
• Tomography Scanners, X-Ray Computed
• Tomography, X-Ray Computed
• economics
• radiography
• hsrmtgs

Other ID:

• HTX/98619973

UI: 102234537

From Meeting Abstracts