Resource-intensive endoscopic procedures: do the dollars make sense?
BACKGROUND
The rapid development of endoscopic technologies over the past decade has led to an increased utilization of resource-intensive endoscopic procedures in clinical practice. These procedures are technically challenging, time consuming, and typically involve major equipment-related costs.


OBJECTIVE
To determine the economics associated with performing resource-intensive endoscopic procedures in a tertiary-referral center


METHODS
A retrospective practice database review.


METHODS
A single, North American tertiary-referral medical center.


METHODS
All the patients whose initial contacts with the medical center were as outpatients for an EUS, EMR, or ERCP between July and November 2004.


METHODS
Hospital charges, the cost of providing services, revenue, and net income from all services provided through June 2006.


RESULTS
Seventy patients were tracked. During the review period, these 70 patients generated a total of $2.9 million, or $42,126 per patient, in hospital charges. The net profit was $407,263 ($5790 per patient). Endoscopic services alone resulted in a loss of $424 per patient. Surgical services generated just over $300,000 in net profit.


CONCLUSIONS
Economics for only resource-intensive endoscopic procedures are not financially viable under the current health care reimbursement system. The first step to removing disincentives to performing these cost-effective procedures would appear to be an insistence that reimbursement be weighted equitably to ensure reasonable profitability.
Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, USA.
Andrew S
AS
Ross
Joel
J
Roth
Irving
I
Waxman
D016208:Databases, Factual; D004469:Economics, Hospital; D004724:Endoscopy / Q000191:economics*; D005251:Fees, Medical; D006801:Humans; D006278:Medicare / Q000191:economics; D012189:Retrospective Studies; D014481:United States