Early advanced imaging with CT, MR, or nuclear scintigraphy, especially on the day before or the day of patient admission, leads to shorter inpatient stays, according to a new study in the April issue of the Journal of the American College of Radiology. And shorter inpatient stays could mean lower healthcare costs.
"Inpatient costs represent 18% of total healthcare insurance premium paid, and they continue to grow by approximately 8% annually," wrote lead author Dr. Juan Batlle, of Massachusetts General Hospital in Boston, and colleagues. "The inpatient portion of healthcare expenditure is therefore often scrutinized as a source for potential cost savings."
The researchers found that out of a cohort of patients who were in the hospital for three days or more, those patients who underwent imaging early had a mean length of stay of 8.6 days versus nine days (p = 0.015) (JACR, April 2010, Vol. 7:4, pp. 269-276).
The team identified 10,005 admissions out of 33,226 in 2005 that included one or more advanced imaging study during the period from the first day before admission (-1) through the patient's discharge. The team calculated the length of stay, and using the date of the first imaging study performed relative to the date of admission, the residual length of stay (length of stay minus date of service).
Length of stay was shorter for those imaged on day -1 or 0 compared with day 1 or 2 for all admissions of three or more days:
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The average cost of a hospital stay is $2,129 per day, according to the researchers. With these shorter lengths of stay, the estimated decrease in cost for the one-year period analyzed in the study is about $2,129 per admission, or more than $21 million across the study's population of 10,005 patients.
"Although the study design does not establish cause and effect, our results suggest that early imaging could expedite inpatient care and discharge in certain types of patients, but they do not imply that automatic ordering of imaging should replace clinical judgment," Batlle and colleagues wrote.
By Kate Madden Yee
AuntMinnie.com staff writer
April 1, 2010
Related Reading
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One-quarter of outpatient CT and MR exams are inappropriate, March 1, 2010
CDC report: MRI, CT, PET use spikes in physician offices, ER, February 18, 2010
NEJM study: Imaging procedures, radiation growing, August 26, 2009
MedPAC: Self-referring docs use more imaging, June 23, 2009
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