The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as ‘‘the stethoscope of the 21st century’’. However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost– Benefit Analysis ‘‘ex ante’’, with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ltrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an InternalMedicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets), other than evident medical benefits .

Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department

Francesconi, Andrea
2015-01-01

Abstract

The economic crisis, the growing healthcare demand, and Defensive Medicine wastefulness, strongly recommend the restructuring of the entire medical network. New health technology, such as bedside ultrasonography, might successfully integrate the clinical approach optimizing the use of limited resources, especially in a person-oriented vision of medicine. Bedside ultrasonography is a safe and reliable technique, with worldwide expanding employment in various clinical settings, being considered as ‘‘the stethoscope of the 21st century’’. However, at present, bedside ultrasonography lacks economic analysis. We performed a Cost– Benefit Analysis ‘‘ex ante’’, with a break-even point computing, of bedside ultrasonography implementation in an Internal Medicine department in the mid-term. Number and kind estimation of bedside ltrasonographic studies were obtained by a retrospective study, whose data results were applied to the next 3-year period (foresight study). All 1980 foreseen bedside examinations, with prevailing multiorgan ultrasonographic studies, were considered to calculate direct and indirect costs, while specific and generic revenues were considered only after the first semester. Physician professional training, equipment purchase and working time represented the main fixed and variable cost items. DRG increase/appropriateness, hospitalization stay shortening and reduction of traditional ultrasonography examination requests mainly impacted on calculated revenues. The break-even point, i.e. the volume of activity at which revenues exactly equal total incurred costs, was calculated to be 734 US examinations, corresponding to € 81,998 and the time considered necessary to reach it resulting 406 days. Our economic analysis clearly shows that bedside ultrasonography implementation in clinical daily management of an InternalMedicine department can produce consistent savings, or economic profit according to managerial choices (i.e., considering public or private targets), other than evident medical benefits .
2015
Testa, Americo; Giannuzzi, Rosangela; Berardi, Silvia; Sbraccia, Paolo; Francesconi, Andrea
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/114465
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 24
  • ???jsp.display-item.citation.isi??? 20
social impact