title: Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.
abstract: OBJECTIVE
  Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice.
  
  
  METHODS
  Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds.
  
  
  RESULTS
  Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost.
  
  
  CONCLUSIONS
  Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees.
  
  
  CONCLUSIONS
  • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.
authors.affiliation: Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ernst Moritz Arndt University, Ferdinand-Sauerbruch-Str. 1, 17475, Greifswald, Germany. rosenberg@uni-greifswald.de
authors.forename: Christian
authors.initials: C
authors.lastname: Rosenberg
authors.forename: Kristin
authors.initials: K
authors.lastname: Kroos
authors.forename: Britta
authors.initials: B
authors.lastname: Rosenberg
authors.forename: Norbert
authors.initials: N
authors.lastname: Hosten
authors.forename: Steffen
authors.initials: S
authors.lastname: Flessa
mesh_terms: D003362:Cost-Benefit Analysis; D005858:Germany; D017048:Health Care Costs; D006785:Hospitals, University / Q000191:economics* / Q000458:organization & administration*; D006801:Humans; D018803:Models, Economic; D009010:Monte Carlo Method; D011871:Radiology / Q000191:economics* / Q000379:methods*; D017216:Telemedicine / Q000191:economics* / Q000379:methods*