Radiologist preferences driving significant cost variability in common imaging-guided procedures
Radiologist device preferences may be driving cost variability in common imaging-guided procedures, according to a new single-center study published Saturday.
Stanford University experts recently took a closer look at this issue, analyzing nine rads’ use of expendable items during nearly a dozen different procedures. They discovered high variability from one type of treatment to the next, including a nearly 57% coefficient of variation rate for radioembolization administration.
Scientists believe the data underline the need to educate radiologists about standardizing their device preferences to help curb costs and deliver value.
“These findings suggest that there may be a high degree of practice variation in [interventional radiology],” corresponding author Nishita Kothary, MD, an IR professor with Stanford University Medical Center, and co-authors wrote March 27 in the Journal of Vascular and Interventional Radiology. “Identifying these variations, addressing them through physician education, and creating standard guidelines may represent a path to progress toward cost-efficiency.”
For the study, Kothary et al. gathered data from the hospital’s analytics system logged during the two years ending in October 2019. Their search yielded nearly 45,000 items used across more than 2,100 interventional radiology procedures. Researchers also calculated the mean cost per case for each doc, along with the mean, standard deviation and coefficient of variation of the mean cost per case across physicians.
Radioembolization administration had the highest tally of variation at 56.6% while transjugular liver biopsy landed lowest at 4.9%. Variation in transarterial chemoembolization costs, they noted, was primarily driven by the use of different microcatheters or microwires. In nephrostomy, the choice of wires resulted in a twofold increase in spending by the highest spender compared to the lowest. Mean expenditures by radiologist were not significantly correlated with case volume, they added.
“These results have significant implications for interventions promoting value-based care in IR when the value is defined as the outcome of a particular procedure or treatment divided by its cost,” Kothary and colleagues advised. “While labor costs are considerable, nonlabor costs that include expendable supplies account for a substantial share of the total cost,” they added later.
You can read much about their project in the Society of Interventional Radiology’s official journal here.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.