[What's the price of routine sonography--results of an analysis of costs and processes in a district hospital].
OBJECTIVE
The introduction of Diagnostic Related Groups (DRG) in hospitals also requires a calculation of the costs for material and staff to perform ultrasonographic examinations. Ultrasonography is currently not part of the regular procedure catalog of the DRG. Is ultrasonography for inpatients cost-effective? How much is a given examination today? The goal of this study was the analysis of examination times, times during which staff is required, and non-personnel costs for defined activities within an ultrasound department.


METHODS
Within three weeks we registered all activities which included 692 ultrasound examinations. We analyzed repetitive processes as well as selected procedures. The performances were registered including all activities by medical and non-medical staff. We calculated the complete non-personnel and following costs and also considered the different levels of qualification of the examiners (DEGUM-Level 1 or 2).


RESULTS
With this method we were able to precisely determine the costs for frequent ultrasonographic examinations. The time of an abdominal ultrasound examination was 16 minutes. The costs for an inpatient abdominal ultrasound were under conditions of public institutions tariff east (90% of west tariff) 35.70 euros, for an emergency ultrasound 41.82 euros, for a contrast-enhanced ultrasound 105.91 euros and for an ultrasound-guided puncture 97.05 euros. For examinations of higher qualified staff (DEGUM 2), 4.29 euros were added to the basic costs. The revenue for abdominal sonography and puncture in the ambulant setting is by no means cost-effective.


CONCLUSIONS
In this article we show the dimension of costs for ultrasound in the inpatient setting and make it calculable. We show what resources it requires to perform ultrasound. In perspective the next step will be the comparison and evaluation of the efficiency of the different imaging methods, but that was not the aim of this study.
Nürnberg
D
D
Gastroenterologie, Ruppiner Kliniken, Neuruppin. d.nuernberg@ruppiner-kliniken.de
Jung
A
A
Schmieder
C
C
Schmidt
M
M
Holle
A
A
D000005:Abdomen / Q000000981:diagnostic imaging*; D002983:Clinical Competence / Q000191:economics; D003287:Contrast Media / Q000191:economics; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups / Q000191:economics; D004630:Emergencies / Q000191:economics; D005858:Germany; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006767:Hospitals, District / Q000191:economics*; D006801:Humans; D010348:Patient Care Team / Q000191:economics; D012017:Referral and Consultation / Q000191:economics; D013996:Time and Motion Studies; D014463:Ultrasonography / Q000191:economics*
D003287:Contrast Media