title: Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden.
abstract: OBJECTIVE
  The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations.
  
  
  METHODS
  This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skåne, Sweden.
  
  
  RESULTS
  From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography.
  
  
  CONCLUSIONS
  Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.
authors.affiliation: Department of Healthcare Governance, Region Skåne, Malmö, Sweden.
authors.forename: Alexander
authors.initials: A
authors.lastname: Dozet
authors.affiliation: Medicine Service University Trust, Region Skåne, Department of Cardiothoracic Surgery, Skåne University Hospital and Lund University, Lund, Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Ivarsson
authors.affiliation: Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Eklund
authors.affiliation: Hospital Management, Skåne University Hospital, Malmö, Sweden.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Klefsgård
authors.affiliation: Department of Radiology, Örebro University, Örebro, Sweden.|Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Mats
authors.identifier: http://orcid.org/0000-0003-0529-7723
authors.initials: M
authors.lastname: Geijer
mesh_terms: D020811:Biomedical Technology / Q000191:economics*; D003362:Cost-Benefit Analysis; D006801:Humans; D008952:Mobile Health Units / Q000191:economics*; D009735:Nursing Homes; D019095:Point-of-Care Systems / Q000191:economics; D011446:Prospective Studies; D011871:Radiology; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: X-ray equipment; cost minimization technique; cost-effectiveness; evaluation; mobile radiography; residential aged care