Cost analysis of contrast-enhanced cranial MRI at a German university hospital

Purpose: Detailed evaluation and cost analysis of a cranial contrast-enhanced MRI (c-ceMRI) in outpatients, inpatients, patients in an intensive care unit and children under anesthesia. Materials and Methods: Based on a detailed process-oriented model, we calculated the cost of a cranial MRI for the four situations mentioned above. A comprehensive evaluation of the overhead and personnel costs was performed. Results: We performed 5108 MRI examinations on 2 scanners in the year 2008. 2150 examinations (42 %) were identified as c-ceMRI. For inpatients we calculated a total cost of Euro 242.46 per examination with a personnel cost of Euro 81.71 for the radiological department. In outpatients we calculated total costs of Euro 181.97 with radiological personnel costs of Euro 68.67. Patients coming from an intensive care unit were treated by an intensive care team, which resulted in total costs of Euro 416.58 with Euro 283 in costs for radiological personnel (32.8 %). MRI examinations of children under anesthesia resulted in costs of Euro 616.79 for the hospital, of which Euro 285.78 were radiological personnel costs (34.5 %). Conclusion: In this study we evaluated for the first time different radiological scenarios of a c-ceMRI at a university hospital. Considering the present reimbursement situation, all outpatients covered by statutory health insurance resulted in a deficit for the hospital. Particularly high costs for patients in intensive care units as well as for children under anesthesia have to be taken into account and are currently not adequately covered by care providers. (orig.)