Limiting oral contrast administration could bring big savings to EDs
Emergency departments (EDs) could see significant cost savings by eliminating oral contrast administration for most patients presenting with nontraumatic abdominal pain, according to a new study published in the Journal of the American College of Radiology.
“There is an ongoing debate regarding the modern necessity of oral contrast in the detection and diagnosis of abdominopelvic pathologies, especially in patients with body mass index (BMI) greater than 25 kg/m2,” wrote Prasad R. Shankar, MD, department of radiology at Michigan Medicine in Ann Arbor, Michigan, and colleagues. “Eliminating oral contrast has been reported to decrease ED length of stay and result in improved ED patient throughput. As ED patient volumes continue to increase, efficiency is gaining importance as a metric of high-value patient care.”
The authors studied data from a one-year period—Jan. 1, 2016, to Dec. 31, 2016—at a single facility, tracking all costs associated with oral contrast administration in the ED for patients with nontraumatic abdominal pain. They then estimated the cost savings associated with a potential institutional policy to explore if it was worth considering such a change.
Overall, annual costs for oral contrast in the ED for patients presenting with nontraumatic abdominal pain were estimated to be $82,552. Using internal data, the authors calculated the real annual cost to be $68,780.16.
So, how could that number be reduced? The authors explored a potential policy change that would eliminate oral contrast except for patients falling in one of these three categories:
- with a body mass index less than 25 kg/m2.
- with a history of abdominal surgery within the last 30 days.
- with a history of inflammatory bowel disease.
Shankar and colleagues found that, with that policy in change, annual cost savings would have been $35,836.57, or 52 percent.
“Multidepartmental collaborative efforts can reduce these costs, with further studies needed to accurately identify the populations in which oral contrast may be safely deferred,” the authors wrote. “Prospective studies would be necessary to assess outcomes of risk-adjusted patient populations with and without oral contrast. Assessment of patient preferences and risk tolerance related to oral contrast consumption should also be considered.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.