title: Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial.
abstract: OBJECTIVE
  To evaluate the costs of treatment and use of hospital resources when comparing routine abdominal CT and selective imaging practice based on clinical assessment in patients with acute abdomen.
  
  
  METHODS
  Altogether 300 patients with acute abdominal pain were randomised to computed tomography (CT, n = 150) or selective imaging practice (SIP, n = 150) groups. Final analysis included 254 patients, 143 in the CT and 111 in the SIP group. All CT group patients underwent contrast-enhanced abdominal CT within 24 h of admission. In the SIP group, imaging was individually tailored based on clinical assessment. The numbers of various examinations and procedures as well as costs of treatment arising from acute abdomen were calculated for each patient. Length of hospital stay was registered.
  
  
  RESULTS
  Total treatment cost per patient was 1,202 euros (<euro>) higher in the CT group compared to the SIP group (P = 0.002). The length of hospital stay was 1.2 days longer in the CT group (3.7 vs. 2.5 days, P = 0.010). Routine CT had no impact on ED discharge times. Imaging costs accounted for approximately 10 % of total costs.
  
  
  CONCLUSIONS
  Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.
  
  
  CONCLUSIONS
  • CT is widely used almost routinely in the diagnostics of acute abdomen. • Patients with acute abdomen were randomised to routine CT or selective imaging. • The treatment costs were significantly higher in the routine CT group. • Length of hospital stay was longer in the CT group. • Selective use of imaging may help control continuous increases of treatment costs.
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 1777, FI-70211, Kuopio, Finland. tiina.lehtimaki@kuh.fi
authors.forename: Tiina
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Petri
authors.initials: P
authors.lastname: Juvonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Valtonen
authors.forename: Pekka
authors.initials: P
authors.lastname: Miettinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Paajanen
authors.forename: Ritva
authors.initials: R
authors.lastname: Vanninen
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging* / Q000191:economics*; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000737:chemistry*; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics*; D004635:Emergency Medicine / Q000191:economics; D005260:Female; D005387:Finland; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010351:Patient Discharge; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics*
chemical_list: D003287:Contrast Media