European Radiology

, Volume 23, Issue 9, pp 2538–2545 | Cite as

Impact of routine contrast-enhanced CT on costs and use of hospital resources in patients with acute abdomen. Results of a randomised clinical trial

  • Tiina Lehtimäki
  • Petri Juvonen
  • Hannu Valtonen
  • Pekka Miettinen
  • Hannu Paajanen
  • Ritva Vanninen
HEALTH ECONOMY

Abstract

Objectives

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 (€) 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.

Conclusion

Routine abdominal CT results in higher treatment costs compared to selective use of imaging in patients with acute abdomen.

Key Points

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.

Keywords

Computed tomography Acute abdomen Treatment costs Length of stay Emergency medicine 

Abbreviations

ED

emergency department

ICD-10

International Statistical Classification of Diseases and Related Health Problems, 10th revision

ICU

intensive care unit

NSAP

non-specific abdominal pain

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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Tiina Lehtimäki
    • 1
  • Petri Juvonen
    • 2
  • Hannu Valtonen
    • 5
  • Pekka Miettinen
    • 2
  • Hannu Paajanen
    • 2
    • 4
  • Ritva Vanninen
    • 1
    • 3
  1. 1.Department of Clinical RadiologyKuopio University HospitalKuopioFinland
  2. 2.Gastrointestinal SurgeryKuopio University HospitalKuopioFinland
  3. 3.Department of Clinical Medicine, Unit of RadiologyUniversity of Eastern FinlandKuopioFinland
  4. 4.Department of Clinical Medicine, Unit of SurgeryUniversity of Eastern FinlandKuopioFinland
  5. 5.Department of Health and Social ManagementUniversity of Eastern FinlandKuopioFinland

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