Operating expenses for the diagnosis and treatment of peripheral vascular disease in an academic interventional radiology department:: Cost calculations according to a microeconomic method

PURPOSE: A correct understanding of the true costs of a procedure is necessary to make informed decisions in cost-effectiveness analyses. The actual comprehensive costs of performing cardiovascular and interventional radiology (CVIR) procedures were analyzed in the present study, as opposed to charges or ratios of costs to charges (RCCs), as often used in the literature. MATERIALS AND METHODS: Costs included labor, equipment, administration, facility establishment and maintenance, overhead, and consumable supplies. Cost identification was initially performed with use of an hourly rate that reflected the cost of operating the CVIR section. This was then combined with the costs of the consumable supplies used during each type of procedure. Eight types of vascular procedures were studied in 235 consecutive patients to determine mean procedure duration and supplies consumption. Costs were then compared with charges and RCCs of these procedures. RESULTS: The hourly rate for operating one angiography suite was $690. Average cost by procedure, including hourly rate plus consumable supplies, were: aortic arteriogram, $1,442; aortobifemoral arteriogram, $1,554; unilateral limb arteriogram, $1,307; simple iliac or femoropopliteal angioplasty, $2,119; arterial stent placement, $2,780; percutaneous thrombectomy, $1,998; arterial in situ thrombolysis, $3,133; and arteriogram after thrombolysis, $926. RCCs calculated for each procedure ranged from 0.39 (thrombectomy) to 1.92 (control arteriography during or after thrombolysis) and were lower than expected based on previous reports. CONCLUSIONS: The average actual costs of several common diagnostic and therapeutic procedures for peripheral vascular occlusive disease were established, allowing determination of the relative importance of different cost components. This methodology may serve as a template for future cost analyses.