title: Evaluating blunt abdominal trauma with sonography: a cost analysis.
abstract: Ultrasonography (US) is becoming increasingly utilized in the United States for the evaluation of blunt abdominal trauma (BAT). The objective of this study was to assess the cost impact of utilizing US in the evaluation of patients with BAT in a major trauma center. All patients sustaining BAT during a 6-month period before US was used at our institution (Jan-Jun 1993) were compared to BAT patients from a recent period in which US has been utilized (Jan-Jun 1995). The numbers of US, computed tomography (CT), and diagnostic peritoneal lavage (DPL) were tabulated for each group. Financial cost for each of these procedures as determined by our finance department were as follows: US $96, CT $494, DPL $137. These numbers are representative of actual hospital expenditures exclusive of physician fees as calculated in 1994 U.S. dollars. Cost analysis was performed with t test and chi squared test, and significance was defined as P < 0.05. There were 890 BAT admissions in the 1993 study period and 1033 admissions in the 1995 study period. During the 1993 period, 642 procedures were performed on the 890 patients to evaluate the abdomen: 0 US, 466 CT, and 176 DPL (see table) [table: see text]. This compares to 801 procedures on the 1,033 patients in 1995: 552 US, 228 CT, and 21 DPL. Total cost was $254,316 for the 1993 group and $168,501 for the 1995 group. Extrapolated to a 1-year period, a significant (P < 0.05) cost savings of $171,630 would be realized. Cost per patient evaluated was significantly reduced from $285.75 in 1993 to $163.12 in 1995 (P < 0.05). This represents a 43 per cent reduction in per patient expenditure for evaluating the abdomen. By effectively utilizing ultrasonography in the evaluation of patients with blunt abdominal trauma, a significant cost savings can be realized. This effect results chiefly from an eight-fold reduction in the use of DPL, and a two-fold reduction in the use of CT.
authors.affiliation: Department of Surgery, University of Miami School of Medicine, Florida 33101, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: McKenney
authors.forename: K L
authors.initials: KL
authors.lastname: McKenney
authors.forename: J J
authors.initials: JJ
authors.lastname: Hong
authors.forename: R
authors.initials: R
authors.lastname: Compton
authors.forename: S M
authors.initials: SM
authors.lastname: Cohn
authors.forename: O C
authors.initials: OC
authors.lastname: Kirton
authors.forename: D V
authors.initials: DV
authors.lastname: Shatz
authors.forename: D
authors.initials: D
authors.lastname: Sleeman
authors.forename: P M
authors.initials: PM
authors.lastname: Byers
authors.forename: E
authors.initials: E
authors.lastname: Ginzburg
authors.forename: J
authors.initials: J
authors.lastname: Augenstein
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000191:economics*; D000328:Adult; D003365:Costs and Cost Analysis; D006801:Humans; D010533:Peritoneal Lavage / Q000191:economics; D014057:Tomography, X-Ray Computed / Q000191:economics; D014463:Ultrasonography / Q000191:economics; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000191:economics*