For the study, researchers analyzed the changes in volume, type and cost of facial imaging examinations for the years 1992 and 2002 at a level 1 trauma center. The results showed that in 1992, 890 patients were evaluated for facial trauma, with 671 undergoing X-ray examinations only, 153 CT only and 66 both examinations. In 2002, 828 patients were evaluated, with 584 undergoing CT only, 228 X-ray only and 16 both examinations. The 2002 hospital cost of a facial CT examination was $121 and for an X-ray examination was $154, resulting in an overall cost savings of 22% per patient in 2002.
"The reason for the investigation was that the volume of CT use for emergency trauma had been on an obvious upward trajectory, so there has been some concern among hospital CEOs and third-party payers that it's too expensive to use," said Robert A. Novelline, MD, one of the authors of the study.
According to the authors, the findings are easily explained. "What lowers the cost is the time taken up by facial examinations. Currently it takes 25 minutes for an X-ray versus 10 seconds for CT. That's less room use and less technologist time," said Dr. Novelline.
The main focus of the study was money saved by the hospital, but the benefits also affect the patient, according to Dr. Novelline. "CT is more accurate and better depicts anatomy than an X-ray, so surgeons can better plan surgical treatment for the patient. CT is also faster, which is of great importance in an emergency room setting," he said.
Although the study looked specifically at facial trauma, the study authors say that the results are relevant to all emergency medicine imaging.
The article appears in the September 2004 issue of the American Journal of Roentgenology.
American Journal of Roentgenology