The Role of Physician-Driven Device Preference in the Cost Variation of Common Interventional Radiology Procedures.

Journal Article (Journal Article)

Purpose

To analyze the impact of physician-specific equipment preference on cost variation for procedures typically performed by interventional radiologists at a tertiary care academic hospital.

Materials and methods

From October 2017 to October 2019, data on all expendable items used by 9 interventional radiologists for 11 common interventional radiology procedure categories were compiled from the hospital analytics system. This search yielded a final dataset of 44,654 items used in 2,121 procedures of 11 different categories. The mean cost per case for each physician as well as the mean, standard deviation, and coefficient of variation (CV) of the mean cost per case across physicians were calculated. The proportion of spending by item type was compared across physicians for 2 high-variation, high-volume procedures. The relationship between the mean cost per case and case volume was examined using linear regression.

Results

There was a high variability within each procedure, with the highest and the lowest CV for radioembolization administration (56.6%) and transjugular liver biopsy (4.9%), respectively. Variation in transarterial chemoembolization cost was mainly driven by microcatheters/microwires, while for nephrostomy, the main drivers were catheters/wires and access sets. Mean spending by physician was not significantly correlated with case volume (P =.584).

Conclusions

Physicians vary in their item selection even for standard procedures. While the financial impact of these differences vary across procedures, these findings suggest that standardization may offer an opportunity for cost savings.

Full Text

Duke Authors

Cited Authors

  • Shivakumar, V; Bundorf, MK; Vezeridis, AM; Kothary, N

Published Date

  • May 1, 2021

Published In

Volume / Issue

  • 32 / 5

Start / End Page

  • 672 - 676

PubMed ID

  • 33781687

Electronic International Standard Serial Number (EISSN)

  • 1535-7732

International Standard Serial Number (ISSN)

  • 1051-0443

Digital Object Identifier (DOI)

  • 10.1016/j.jvir.2021.01.275

Language

  • eng