Objective: To evaluate the per-procedure cost of flexible cystoscopy in relation to reimbursement.
Materials And Methods: Capital, maintenance, reprocessing, labor, and disposable costs were calculated at a high-volume academic institution over the fiscal year 2019. Five-year amortized values were used to calculate reusable cystoscope and automated endoscopic reprocessor (AER) per-procedure cost. Twenty flexible cystoscope procedure cycles were timed and multiplied by prevailing medical office assistant wages to determine labor costs. Medicare and commercially insured reimbursements were queried to evaluate the cost and profitability of cystoscopy.
Results: In total, 3739 flexible cystoscopies were performed with 415 procedures per cystoscope. Total annual costs for capital and maintenance, reprocessing, labor, and disposable supplies was $202,494, $147,969, $128,117, and $121,904, respectively. The per-procedure cost for reusable cystoscopy with AER reprocessing, reusable cystoscopy with a high-level disinfectant (HLD), and theoretical costs of disposable cystoscopy were calculated to be $161, $133, and $222, respectively. The volume of procedures per scope had a significant impact on cost and profitability. The number of procedures per cystoscope performed to have equivalent cost as a disposable scope was, 196 and 145 cystoscopies per cystoscope per year, for AER and HLD-reprocessed cystoscopes, respectively.
Conclusions: There is a considerable contribution of capital equipment, maintenance, labor, and supplies to the cost of cystoscopy with profitability highly depend on the volume of cystoscopies performed for each cystoscope. The use of AER results in higher cost than HLD. Cost-effectiveness of disposable scopes needs to be determined but will vary by clinic volume and site of practice.
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http://dx.doi.org/10.1016/j.urology.2021.05.008 | DOI Listing |
PLoS One
January 2025
Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Background: Establishing and maintaining gamma knife facility incurs significant costs, mandating healthcare institutions to meticulously assess financial implications for sustainability.
Methods: This study explores the financial implications of setting up and operating a Gamma Knife facility, with an aim to ascertain user charges for achieving breakeven. The study was conducted from January to June 2019 at the largest neurosurgery centre of an Institute of National Importance (INI), in Delhi, India.
J Midlife Health
October 2024
Department of Obstetrics and Gynaecology, Southend University Hospital, Southend, UK.
J Arthroplasty
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Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Background: Recent changes in Medicare reimbursement policies have facilitated the shift of primary total joint arthroplasty (TJA) volume to ambulatory surgical centers (ASC). The ASCs potentially provide a more cost-effective alternative to a hospital-setting TJA. This study investigated Medicare primary TJA utilization and reimbursement trends at ASCs compared to inpatient and outpatient settings between 2019 and 2022.
View Article and Find Full Text PDFClin Neuroradiol
November 2024
Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK.
J Soc Cardiovasc Angiogr Interv
October 2024
Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Illinois.
Background: Aortic pseudoaneurysm (AP) is a late complication of aortic repair that, without intervention, carries a high mortality rate. Surgical repair has significant in-hospital mortality and high health care costs. Endovascular stent grafting use is currently limited to branch-free aortic segments or the use of complex fenestrated devices.
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