Calculation of internal costs in a department of diagnostic radiology.

Even though high technology accounts for less than 1% of health care costs in industrialized countries, radiology is often blamed for their escalation. In a squeezed health care economy it is important to know the real cost of diagnostic radiological procedures in order to set priorities and realistic budgets, and to bill (actually or fictively) referring departments, physician's patients, insurance companies etc., and to demonstrate real costs of radiology for politicians and clinicians. The so-called Radiology Points used in the Nordic countries are in our opinion not adequate as basis for "price tags", even if to some extent they do reflect work and expenses involved in an examination. The real costs of ultrasonography (US) and excretory urography (UG) of the upper urinary tract have been compared in a study being performed to determine whether US can replace UG as the first examination in upper urinary tract disease. The cost of US is 53% (high osmolar contrast media) or 27% (anionic contrast media) of UG. If US can replace UG as the first examination in upper urinary tract disease the cost savings will be dramatic, especially if low osmolar or anionic contrast media are routinely used.