Vesicoureteral Reflux Imaging in Children: Comparative Cost Analysis

Abstract

Rationale and Objectives The purpose of this study was to compare the costs of voiding cystourethrography (VCUG) versus radionuclide cystography (RNC) for evaluation of vesicoureteral reflux in children. Materials and Methods The variable direct costs of performing 25 VCUG and 25 RNC examinations in age- and general health–matched patients suspected of having vesicoureteral reflux was determined by using time and motion analyses. All personnel directly involved in the cases were tracked, and the involvement times were recorded to the nearest minute. All material items used during the procedures were recorded. The cost of labor was determined from personnel reimbursement data, and the cost of materials, from vendor pricing. The fixed direct costs were assessed from hospital accounting records. Mean, standard deviation, and 95% confidence interval (CI) were determined for all direct (fixed and variable) costs. The total costs were determined for each procedure and compared by using the Student t test. Results There was a significant difference ( P < .0001) between the mean total direct cost of VCUG ($112.17 ± 10.33) and that of RNC ($64.58 ± 1.91). VCUG examination for vesicoureteral reflux in children cost 1.74 times more than RNC examination (95% CI: 1.28, 2.36). Conclusion When the technique is clinically appropriate, institutions may obtain substantial cost savings by using RNC in place of VCUG for examining children suspected of having vesicoureteral reflux.