5:36 PM, Abstract No. 166 - Safety of common cross sectional interventional procedures performed under moderate sedation in the outpatient setting

Abstract

largest contributor to transarterial chemoembolization operating costs. Here, we identify major contributors to operating cost variation for common interventional radiology procedures. We hope that such information may help identify new strategies for improved cost efficiency and overall value (successful outcome/cost). Materials and Methods: All total equipment and procedure suite costs for consecutive successful primary percutaneous nephrostomy tube (PCN) (25 cases), chest wall port (117 cases) and inferior vena cava (IVC) filter (41 cases) placements were analyzed over a three-month period, as part of division quality improvement efforts. Actual procedure suite costs were estimated with a conservative cost of $600/hour. Cost variation was analyzed per procedure and per provider to identify major contributing factors. Results: For PCN, chest wall port and IVC filter placements, the average patient time in procedure suite was 131 min, 112 min, and 127 min, respectively. The average total cost per procedure per provider varied as much as 100% ($1126-2251) for PCN placements, 41% ($1374-1934) for chest wall ports and 22% ($2185-2681) for IVC filters. The equipment cost varied as much as 88% ($249-466), 20% ($491-591) and 27% ($1065-1358) respectively, between different providers. However, the largest contributing factor to cost variation was total procedure suite time, which accounted for 79% ($1373/1732), 67% ($1127/1672) or 53% ($1306/2482) of the total cost, respectively. Thus, despite large variations in equipment cost, ultimately total costs correlated more closely with total procedure suite time. Conclusion: Despite vast differences in equipment cost between different operators for these common procedures within the same department, the largest contributor to overall cost remains patient in procedure suite time despite utilizing a conservative, low estimate for actual cost to operate a procedure suite. These findings suggest that utilization of equipment, which allows for expedient procedure resolution, regardless of cost, may be paradoxically more cost effective overall for select routine procedures.