Hansel Javier Otero MD, Presenter: Nothing to Disclose

Silvia Ondategui-Parra MD, MPH, Abstract Co-Author: Nothing to Disclose

Sukru Mehmet Erturk MD, Abstract Co-Author: Nothing to Disclose

John R Fernandez, Abstract Co-Author: Nothing to Disclose

Pablo Riera Ros MD, Abstract Co-Author: Nothing to Disclose

To evaluate trends and determine financial implications of imaging utilization in management of intestinal obstruction during the fiscal years 1999–2004.

Data on hospital charges was obtained for all patients (n= 1535) discharged with a diagnosis of intestinal obstruction from the TSI database of a large teaching hospital in Massachusetts. The study was approved by the hospital’s institutional review board. Statistical analyses included descriptive analyses, Student’s t-test, and Pearson’s correlation test. Significance was set at a p value of 0.01.

The average number of CT scans per patient increased from 0.97 to 1.73 (p0.1). CT charges represented 72 % of imaging charges at the end of the study period (up from 50.3% during FY1999) and X-ray charges represented 11.75% of the imaging charges in 2004 (down from 24% in FY1999). CT charges increased 177.6% and total imaging charges 91.5%. Imaging charges as a fraction of total hospital charges remained constant representing between 8.7 and 9.2%; average hospital charges increased 80.9% from $18,138 to $32,808. The average length of stay (ALOS) remained between 6.1 and 7.2 days whereas mortality rate (deaths/1000 pts) dropped from 38.31 to 4.03, the percentage of surgical interventions and ICU utilization increased from 25.67% to 39.52% and from 5.36% to 7.66% respectively (p< 0.01); payers’ mix remained constant.

CT utilization and charges increased significantly. This was not due to technology substitution. Hospital charges also increased significantly but the fraction represented by imaging remained constant, therefore the increased CT utilization and charges did not droved up the hospital utilization and charges. There has been a significant improvement in the outcome of patients with diagnosis of intestinal obstruction; imaging technologies might be partly responsible for this.

Increase CT utilization and charges in the management of intestinal obstruction are not major drivers of rising hospital charges and might have a positive impact in patients outcomes.

Otero, H, Ondategui-Parra, S, Erturk, S, Fernandez, J, Ros, P, The Influence of Imaging in Intestinal Obstruction Management Rising Costs.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4437833.html