Imaging utilization in the management of appendicitis and its impact on hospital charges

Hansel J. Otero, Silvia Ondategui-Parra, Sukru Mehmet Erturk, Roberto E. Ochoa, Aldo Gonzalez-Beicos, Pablo R. Ros

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The objective of this study is to assess the trends in imaging utilization in adults with diagnosis of appendicitis and the role that imaging plays in the escalating appendicitis hospital charges. Data on demographics, imaging utilization, and charges of all patients discharged after a diagnosis of appendicitis during 6 years (1999-2004) were obtained from the integrated database of a large hospital. The number of discharges from 1999 to 2004 in the institution steadily decreased. An average of 2.34 imaging studies per patient were obtained, increasing from 1.85 in 1999 to 3.07 in 2004 (p = 0.001). Computed tomography (CT) studies represented 65.9% of the total of studies obtained, while plain films and ultrasound represented 19 and 14%, respectively. The percentage of patients who underwent CT increased from 51.4 to 75.7%, with relative decreases of 12 and 54% for plain abdominal films and ultrasound, respectively. Patients older than 65 years had higher rates of imaging utilization, averaging 4.3 compared with 1.86 studies in their younger counterparts (p = 0.001). Imaging utilization rates did not significantly differ among races (p > 0.5), genders (p > 0.8), discharge services (p > 0.1), or payer groups (p > 0.5). Average hospital charges for appendicitis increased by 16.3%, while imaging charges increased as a fraction of hospital charges from 7.89 to 10.87%. Imaging utilization has increased rapidly, but trends show a slowdown that might correspond with achievement of standardization. This suggests that long-term continuous rising is unlikely. Imaging charges correlate with increased hospital charges but cannot explain or accurately predict them.

Original languageEnglish (US)
Pages (from-to)23-28
Number of pages6
JournalEmergency Radiology
Volume15
Issue number1
DOIs
StatePublished - Jan 2008
Externally publishedYes

Fingerprint

Hospital Charges
Appendicitis
Motion Pictures
Tomography
Demography
Databases

Keywords

  • Appendicitis
  • CT
  • Hospital charges
  • Imaging utilization
  • Plain abdominal films
  • US

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Imaging utilization in the management of appendicitis and its impact on hospital charges. / Otero, Hansel J.; Ondategui-Parra, Silvia; Erturk, Sukru Mehmet; Ochoa, Roberto E.; Gonzalez-Beicos, Aldo; Ros, Pablo R.

In: Emergency Radiology, Vol. 15, No. 1, 01.2008, p. 23-28.

Research output: Contribution to journalArticle

Otero, Hansel J. ; Ondategui-Parra, Silvia ; Erturk, Sukru Mehmet ; Ochoa, Roberto E. ; Gonzalez-Beicos, Aldo ; Ros, Pablo R. / Imaging utilization in the management of appendicitis and its impact on hospital charges. In: Emergency Radiology. 2008 ; Vol. 15, No. 1. pp. 23-28.
@article{533fe4765fd940b2bb250185fbfcb42b,
title = "Imaging utilization in the management of appendicitis and its impact on hospital charges",
abstract = "The objective of this study is to assess the trends in imaging utilization in adults with diagnosis of appendicitis and the role that imaging plays in the escalating appendicitis hospital charges. Data on demographics, imaging utilization, and charges of all patients discharged after a diagnosis of appendicitis during 6 years (1999-2004) were obtained from the integrated database of a large hospital. The number of discharges from 1999 to 2004 in the institution steadily decreased. An average of 2.34 imaging studies per patient were obtained, increasing from 1.85 in 1999 to 3.07 in 2004 (p = 0.001). Computed tomography (CT) studies represented 65.9{\%} of the total of studies obtained, while plain films and ultrasound represented 19 and 14{\%}, respectively. The percentage of patients who underwent CT increased from 51.4 to 75.7{\%}, with relative decreases of 12 and 54{\%} for plain abdominal films and ultrasound, respectively. Patients older than 65 years had higher rates of imaging utilization, averaging 4.3 compared with 1.86 studies in their younger counterparts (p = 0.001). Imaging utilization rates did not significantly differ among races (p > 0.5), genders (p > 0.8), discharge services (p > 0.1), or payer groups (p > 0.5). Average hospital charges for appendicitis increased by 16.3{\%}, while imaging charges increased as a fraction of hospital charges from 7.89 to 10.87{\%}. Imaging utilization has increased rapidly, but trends show a slowdown that might correspond with achievement of standardization. This suggests that long-term continuous rising is unlikely. Imaging charges correlate with increased hospital charges but cannot explain or accurately predict them.",
keywords = "Appendicitis, CT, Hospital charges, Imaging utilization, Plain abdominal films, US",
author = "Otero, {Hansel J.} and Silvia Ondategui-Parra and Erturk, {Sukru Mehmet} and Ochoa, {Roberto E.} and Aldo Gonzalez-Beicos and Ros, {Pablo R.}",
year = "2008",
month = "1",
doi = "10.1007/s10140-007-0678-x",
language = "English (US)",
volume = "15",
pages = "23--28",
journal = "Emergency Radiology",
issn = "1070-3004",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Imaging utilization in the management of appendicitis and its impact on hospital charges

AU - Otero, Hansel J.

AU - Ondategui-Parra, Silvia

AU - Erturk, Sukru Mehmet

AU - Ochoa, Roberto E.

AU - Gonzalez-Beicos, Aldo

AU - Ros, Pablo R.

PY - 2008/1

Y1 - 2008/1

N2 - The objective of this study is to assess the trends in imaging utilization in adults with diagnosis of appendicitis and the role that imaging plays in the escalating appendicitis hospital charges. Data on demographics, imaging utilization, and charges of all patients discharged after a diagnosis of appendicitis during 6 years (1999-2004) were obtained from the integrated database of a large hospital. The number of discharges from 1999 to 2004 in the institution steadily decreased. An average of 2.34 imaging studies per patient were obtained, increasing from 1.85 in 1999 to 3.07 in 2004 (p = 0.001). Computed tomography (CT) studies represented 65.9% of the total of studies obtained, while plain films and ultrasound represented 19 and 14%, respectively. The percentage of patients who underwent CT increased from 51.4 to 75.7%, with relative decreases of 12 and 54% for plain abdominal films and ultrasound, respectively. Patients older than 65 years had higher rates of imaging utilization, averaging 4.3 compared with 1.86 studies in their younger counterparts (p = 0.001). Imaging utilization rates did not significantly differ among races (p > 0.5), genders (p > 0.8), discharge services (p > 0.1), or payer groups (p > 0.5). Average hospital charges for appendicitis increased by 16.3%, while imaging charges increased as a fraction of hospital charges from 7.89 to 10.87%. Imaging utilization has increased rapidly, but trends show a slowdown that might correspond with achievement of standardization. This suggests that long-term continuous rising is unlikely. Imaging charges correlate with increased hospital charges but cannot explain or accurately predict them.

AB - The objective of this study is to assess the trends in imaging utilization in adults with diagnosis of appendicitis and the role that imaging plays in the escalating appendicitis hospital charges. Data on demographics, imaging utilization, and charges of all patients discharged after a diagnosis of appendicitis during 6 years (1999-2004) were obtained from the integrated database of a large hospital. The number of discharges from 1999 to 2004 in the institution steadily decreased. An average of 2.34 imaging studies per patient were obtained, increasing from 1.85 in 1999 to 3.07 in 2004 (p = 0.001). Computed tomography (CT) studies represented 65.9% of the total of studies obtained, while plain films and ultrasound represented 19 and 14%, respectively. The percentage of patients who underwent CT increased from 51.4 to 75.7%, with relative decreases of 12 and 54% for plain abdominal films and ultrasound, respectively. Patients older than 65 years had higher rates of imaging utilization, averaging 4.3 compared with 1.86 studies in their younger counterparts (p = 0.001). Imaging utilization rates did not significantly differ among races (p > 0.5), genders (p > 0.8), discharge services (p > 0.1), or payer groups (p > 0.5). Average hospital charges for appendicitis increased by 16.3%, while imaging charges increased as a fraction of hospital charges from 7.89 to 10.87%. Imaging utilization has increased rapidly, but trends show a slowdown that might correspond with achievement of standardization. This suggests that long-term continuous rising is unlikely. Imaging charges correlate with increased hospital charges but cannot explain or accurately predict them.

KW - Appendicitis

KW - CT

KW - Hospital charges

KW - Imaging utilization

KW - Plain abdominal films

KW - US

UR - http://www.scopus.com/inward/record.url?scp=36649002508&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36649002508&partnerID=8YFLogxK

U2 - 10.1007/s10140-007-0678-x

DO - 10.1007/s10140-007-0678-x

M3 - Article

VL - 15

SP - 23

EP - 28

JO - Emergency Radiology

JF - Emergency Radiology

SN - 1070-3004

IS - 1

ER -