COMPARISON OF DIRECT AND INDIRECT COSTS OF MAGNETIC RESONANCE AND COMPUTED TOMOGRAPHY IN THE EVALUATION OF INCIDENTAL ADRENAL MASSES

Mutlu Güneş

Makale detayları

COMPARISON OF DIRECT AND INDIRECT COSTS OF MAGNETIC RESONANCE AND COMPUTED TOMOGRAPHY IN THE EVALUATION OF INCIDENTAL ADRENAL MASSES

Yazarlar:

Mutlu Güneş

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.25 Issue 1, pp.115-121

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001285105

pISSN:

2148-9645

Anahtar kelimeler:

Özet:

 Objective: It was planned to compare the direct and indirect costs of computed tomography CT and magnetic resonance MR methods in the differentiation of adrenal adenoma and non adenoma. Material and Methods: CT, MR, pathology, laboratory and other information of the patients were obtained from the patient files. Radiological examination and unilateral laparoscopic adrenalectomy cost information was obtained from the accounting department. For cost calculation; the scenario was used in which 500 patients were referred equally to CT and MR, individuals diagnosed with non-adenoma were referred to the operation after the first control, individuals diagnosed with adenoma were followed, and standard follow-up was done every 6 months for 4 years. Results: A total of 31 patients 8 males and 23 females were eligible for the study. The mean age of the patients was 48.117.7 years. In the CT group, an excess cost of 609,0  per person for 1 year and 2435,9  per person for 4 years was incurred. In the diagnosis of adenoma and non-adenoma, CT was inaccurate in 24.4 of patients, whereas MR was inaccurate in 5.2. When used for the diagnosis of pheochromocytoma, it was found that in the CT group, 609,0  per person for 1 year and 2435,9  per person for 4 years resulted in an excess cost, whereas CT was erroneous in 17.6 of patients and MR in 15.8 of patients. In the diagnosis of malignancy, in the CT group, an excess cost of 522,2  per person for 1 year and 2088,7  per person for 4 years was incurred. It was determined that correct decision could not be made in 33.2 of the patients in the CT group and in 5.8 of the patients in the MR group. Conclusion: The use of contrast-enhanced MR in patients of adrenal masses reduces unnecessary interventions and the resulting expenditures.

 Objective: It was planned to compare the direct and indirect costs of computed tomography CT and magnetic resonance MR methods in the differentiation of adrenal adenoma and non adenoma. Material and Methods: CT, MR, pathology, laboratory and other information of the patients were obtained from the patient files. Radiological examination and unilateral laparoscopic adrenalectomy cost information was obtained from the accounting department. For cost calculation; the scenario was used in which 500 patients were referred equally to CT and MR, individuals diagnosed with non-adenoma were referred to the operation after the first control, individuals diagnosed with adenoma were followed, and standard follow-up was done every 6 months for 4 years. Results: A total of 31 patients 8 males and 23 females were eligible for the study. The mean age of the patients was 48.117.7 years. In the CT group, an excess cost of 609,0  per person for 1 year and 2435,9  per person for 4 years was incurred. In the diagnosis of adenoma and non-adenoma, CT was inaccurate in 24.4 of patients, whereas MR was inaccurate in 5.2. When used for the diagnosis of pheochromocytoma, it was found that in the CT group, 609,0  per person for 1 year and 2435,9  per person for 4 years resulted in an excess cost, whereas CT was erroneous in 17.6 of patients and MR in 15.8 of patients. In the diagnosis of malignancy, in the CT group, an excess cost of 522,2  per person for 1 year and 2088,7  per person for 4 years was incurred. It was determined that correct decision could not be made in 33.2 of the patients in the CT group and in 5.8 of the patients in the MR group. Conclusion: The use of contrast-enhanced MR in patients of adrenal masses reduces unnecessary interventions and the resulting expenditures.

 Objective: It was planned to compare the direct and indirect costs of computed tomography CT and magnetic resonance MR methods in the differentiation of adrenal adenoma and non adenoma. Material and Methods: CT, MR, pathology, laboratory and other information of the patients were obtained from the patient files. Radiological examination and unilateral laparoscopic adrenalectomy cost information was obtained from the accounting department. For cost calculation; the scenario was used in which 500 patients were referred equally to CT and MR, individuals diagnosed with non-adenoma were referred to the operation after the first control, individuals diagnosed with adenoma were followed, and standard follow-up was done every 6 months for 4 years. Results: A total of 31 patients 8 males and 23 females were eligible for the study. The mean age of the patients was 48.117.7 years. In the CT group, an excess cost of 609,0  per person for 1 year and 2435,9  per person for 4 years was incurred. In the diagnosis of adenoma and non-adenoma, CT was inaccurate in 24.4 of patients, whereas MR was inaccurate in 5.2. When used for the diagnosis of pheochromocytoma, it was found that in the CT group, 609,0  per person for 1 year and 2435,9  per person for 4 years resulted in an excess cost, whereas CT was erroneous in 17.6 of patients and MR in 15.8 of patients. In the diagnosis of malignancy, in the CT group, an excess cost of 522,2  per person for 1 year and 2088,7  per person for 4 years was incurred. It was determined that correct decision could not be made in 33.2 of the patients in the CT group and in 5.8 of the patients in the MR group. Conclusion: The use of contrast-enhanced MR in patients of adrenal masses reduces unnecessary interventions and the resulting expenditures.

 Amaç: Bilgisayarlı tomografi BT ve manyetik rezonans MR yöntemlerinin adrenal adenom ve non adenom ayrımında direkt ve dolaylı maliyetlerininin karşılaştırılması planlanmıştır. Gereç ve Yöntemler: Hastaların BT, MR, patoloji, laboratuvar ve diğer bilgileri hasta dosyalarından elde edildi. Sosyal Güvenlik Kurumunun kontrastlı BT için 170 Türk Lirası , kontrastlı MR için 202 , tek taraflı laparoskopik sürrenalektomi için 18036  ödeme yaptığı fatura bölümünden öğrenildi. Maliyet hesaplaması için, 500 hastanın eşit olarak BTye ve MRa yönlendirildiği, non adenom tanısı alanların ilk kontrol sonrası operasyona yönlendirildiği, adenom tanısı alanların ise takip edildiği; standart takibin 4 yıl boyunca 6 ayda bir yapıldığı senaryosu kullanıldı. Bulgular: Çalışmaya uygun olan 8 erkek ve 23 kadın olmak üzere 31 hasta tespit edildi. Hastaların yaş ortalaması 48.117.7 idi. BT kolunda 1 yıl için kişi başı 609,0  fazla, 4 yıl için kişi başı 2435,9  maliyet oluşmaktadır. Adenom ve non adenom tanısında BTnin hastaların 24.4ünde, MRın ise hastaların 5.2sinde hatalı karar verdiği görüldü. Feokromasitoma tanısı için kullanıldığında BTnin 1 yıl için kişi başı 609,0 ; 4 yıl için kişi başı 2435,9  fazla maliyet oluşturduğu, buna karşın BTnin hastaların 17.6sında, MRın ise hastaların 15.8inde hatalı karar verdiği tespit edildi. Malignite tanısında BT kolunda 1 yıl için kişi başı 52,2 , 4 yıl için kişi başı 2088,7  fazla maliyet oluşmaktadır. BT grubunda hastaların 33.2sinde, buna karşılık MR grubunda 5.8inde doğru karar verilemediği saptandı. Sonuç: Endokrinoloji polikliniğine yönlendirilen adrenal kitlelerin değerlendirilmesinde kontastlı MR kullanılması gereksiz müdahaleleri ve bundan kaynaklı harcamaları azaltmaktadır.

Makale detayları

COMPARISON OF DIRECT AND INDIRECT COSTS OF MAGNETIC RESONANCE AND COMPUTED TOMOGRAPHY IN THE EVALUATION OF INCIDENTAL ADRENAL MASSES

Yazarlar:

Mutlu Güneş

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.25 Issue 1, pp.115-121

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001285105

pISSN:

2148-9645

Adrenal adenoma

computed tomography

magnetic resonance

Adrenal adenom

bilgisayarlı tomografi

manyetik rezonan

Sayı

Makale detayları

COMPARISON OF DIRECT AND INDIRECT COSTS OF MAGNETIC RESONANCE AND COMPUTED TOMOGRAPHY IN THE EVALUATION OF INCIDENTAL ADRENAL MASSES

Yazarlar: Mutlu Güneş

Yayıncı: Kirikkale University

Ana Başlıklar: Sağlık Kurumları Yönetimi

Dergi: Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.25 Issue 1, pp.115-121

Belge Tipi: Makale

Yayın Tarihi: 4/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001285105

pISSN: 2148-9645

Adrenal adenoma

computed tomography

magnetic resonance

Adrenal adenom

bilgisayarlı tomografi

manyetik rezonan

Sayı

Yazarlar:

Mutlu Güneş

Yayıncı:

Kirikkale University

Ana Başlıklar:

Sağlık Kurumları Yönetimi

Dergi:

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi Vol.25 Issue 1, pp.115-121

Belge Tipi:

Makale

Yayın Tarihi:

4/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001285105

pISSN:

2148-9645