Cost accounting of X-ray diagnostic examinations in the Argos General Hospital

The purpose of this study was to calculate the cost of the X-ray diagnostic examinations in the Argos General Hospital. Up until today, the national health service has not had a complete system applied to account for the cost of the health services (examinations, surgical treatments, etc.) as a result of which we do not know the actual cost of the services provided. All the cost groups have been allocated to the following examinations: simple X-rays (chest X-rays, ischium X-rays, etc.), radioscopies (pyelography, etc.), ultrasounds, mammograms and X-rays taken on the portable X-ray machines. Material-Method Methodologically, this is a prospective study of analyzing and accounting for the cost of the examinations. This has been done taking into consideration the cost groups that play a part in sharing the price of each examination and which are: cost of the equipment's purchase and maintenance, personnel payments, disposable material, cost for rooms and rooms adjustment, general expenses (telephone services, electric power, etc.)» indirect expenses (administrative and assistant personal payments, etc.). The material for this study has been the patients of the X-ray diagnostic department from 1/1/01 to 31/12/01, which come to 30,652 people (in- and outpatients). For every cost group the allocation criterion has been different. For example, the allocation of the cost for the maintenance and repairing of the equipment during the examinations has been based on how long the equipment s lamp was on. Results The study has shown that the cost for each examination is as follows: 8.73 € for a simple X-ray, 18.64 € for a mammogram, 72.68 € for a pyelography, 18.00 € for an ultrasound and 22.00 € for an X-ray using the portable radiological machines. Comparing the prices for the examinations in this study to the governmental rates has made clear the vast variation of the tow. The governmental rates set the cost of the simple X-ray at 4.05 € whereas the cost for the Argos General Hospital is 215.5% higher. Likewise, mammograms are 116.4% more expensive, pyelography 359%, ultrasound 217.4 % and the X-ray from the portable machines 545.2% more expensive than the prices set by the presidential enactment 157. Finally, we tried a comparison of the prices of this study to the prices charged by the private clinics for imaging tests. This comparison has also shown the vast variation between the tow rates. Indicatively, the hospitals “Ygeia” and “Metropolitan” charge 49.28 € for a chest X-ray whereas the governmental rates set its cost at 4.05 € and its actual cost for Argos General Hospital is 8.73 €. Conclusions The discrepancy between the actual cost of the examinations and the governmental rates confirms the need of readjusting the latter on the basis of more rational criteria. This will result in reducing the hospitals' deficit.

Keywords: Cost, radiodiagnostic test, X-ray, mammography, pyelography, ultrasound