[Costs of digestive endoscopy in a level II university hospital]. / Costes de la endoscopia digestiva en un hospital universitario de nivel II.

ABSTRACT

OBJECTIVES: To establish the criteria that should be considered when analyzing the cost of digestive endoscopy and to determine how the variables studied influence the final results, as well as to determine the relative value unit (RVU) per endoscopic procedure. MATERIAL AND METHOD: Clinical management study relating the cost of endoscopic procedures with their complexity, healthcare activity and direct and indirect countable costs. The endoscopic procedures performed from 2000-2001 (4,982 procedures) were analyzed. We determined the staff costs according to the hours devoted to endoscopic activity, the procedures performed and their complexity, non-amortizable and amortizable materials acquired in the study period, and the cost and amortization of apparatus and equipment. RESULTS: The biannual cost was 392,892.60;. Staff costs were 63%, apparatus and equipment 15%, structural costs 13%, pharmacy 6%, materials 2% and amortizable materials 1%. The least expensive procedure was diagnostic gastroscopy (60.56;) and the most expensive was therapeutic endoscopic retrograde cholangiopancreatography (277.06;). The RVU cost was 52.58;. CONCLUSIONS: Calculation of the cost of any medical procedure should take into account the strict application of direct and indirect costs. In our environment, the cost of endoscopy is lower than might be expected, mainly because the cost of amortization of apparatus and equipment and staff costs were low. Calculation of the complexity index is of considerable clinical and healthcare value. Determination of the RVU is a key element in establishing the cost of a procedure and in relating this cost with other costs, allowing its application as well as comparison among different investigations, services and centers.