CT use alone fails to increase costs of hospital stay

Increased use of CT to image pneumonia is unlikely to be the sole cause of increased hospital costs for pneumonia patients, according to a study from Brigham and Women's Hospital in Boston.

In the study, presented at the 2008 RSNA meeting, Michael Lu, Ph.D., a research fellow at Brigham and Women's, and colleagues retrospectively examined 1064 patients with a primary diagnosis of pneumonia from 1999 to 2006. The researchers retrieved information from hospital accounting and administration data.

The average length of stay was 9.2 days, 28.9% of patients were admitted to the intensive care unit, and 18.7% required mechanical ventilation. The all-cause in-hospital mortality rate was 11.5%.

Although the average number of CT studies per patient increased from 1999 to 2006, the average number of imaging studies did not. The number of chest radiographs did not change significantly, with an average of 5.47 during the study period. The percentage of hospital costs remained fairly constant at an average of $20,505. Imaging costs went from $475 in 1999 to $726 in 2006.

Hospital and imaging costs have significantly increased, but the fraction represented by imaging has remained constant. This suggests that imaging is unlikely to be the reason for the cost increase, the researchers said.

It is unclear why the costs increased. The study was meant to show that increased use of CT was not the cause, said presenter Dr. Hansel Otero, a research associate in radiology at Brigham and Women's. A cost-effectiveness study is needed before the reason costs for the hospital jumped can be determined.

The researchers compiled figures from the hospital administration database, and detailed information was left out. This limited the conclusions the researchers could make, he said.

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