Costs, charges, and revenues for hospital diagnostic imaging procedures: differences by modality and hospital characteristics.
OBJECTIVE
This study examined financial data reported by Florida hospitals concerning costs, charges, and revenues related to imaging services.


METHODS
Financial reports to the Florida Hospital Uniform Reporting System by all licensed acute care facilities for fiscal year 2002 were used to calculate four financial indices on a per procedure basis. These included charge, net revenue, operating expense (variable cost), and contribution margin. Analysis, stratified by cost center (imaging modality), tested the effects of bed size, ownership, teaching status, and urban or rural status on the four indices.


RESULTS
The mean operating expense and charge per procedure were as follows: computed tomography (CT): $51 and $1565; x-ray and ultrasound: $55 and $410; nuclear medicine (NM): $135 and $1138; and magnetic resonance imaging (MRI): $165 and $2048. With all four modalities, for-profit hospitals had higher charges than not-for-profit and public facilities. Excepting NM, however, the difference by ownership disappeared when considering net revenue. Operating expense did not differ by ownership type or bed size.


CONCLUSIONS
Operating expense (variable cost) per procedure is considerably lower for CT than for MRI. Consequently, when diagnostically equivalent, CT is preferable to MRI in terms of costs for hospitals. If the cost structure of nonhospital imaging is at all similar to hospitals, the profit potential for performing CT and MRI seems to be substantial, which has relevance to the issue of imaging self-referral.
Sistrom
Christopher Lee
CL
Department of Radiology, University of Florida, Gainesville, Florida 32610, USA.
McKay
Niccie L
NL
D003361:Cost Allocation; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics*; D005375:Financial Audit; D005377:Financial Management, Hospital; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006777:Hospitals, Proprietary / Q000191:economics; D006780:Hospitals, Rural / Q000191:economics; D006786:Hospitals, Urban / Q000191:economics; D006788:Hospitals, Voluntary / Q000191:economics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D006278:Medicare / Q000191:economics; D009683:Nuclear Medicine / Q000191:economics; D011050:Policy Making; D014057:Tomography, X-Ray Computed / Q000191:economics; D014463:Ultrasonography / Q000191:economics; D014481:United States