SFEBES2013 Poster Presentations Bone (34 abstracts)
Audit of cost-saving following introduction of investigation protocol for primary hyperparathyroidism
Adam Skelton 1 , Christopher Smith 1 , Laura McLaren 1 , David Stobo 1 , Stephen Gallacher 1, , Andrew Gallagher 1 , Fergus MacLean 1, & John Hinnie 1
1Infirmary, Glasgow, UK; 2Southern General Hospital, Glasgow, UK.
This group has previously audited the effect of a protocol for investigation of primary hyperparathyroidism (PHP); the protocol stating that only patients meeting criteria for parathyroidectomy should have parathyroid imaging carried out. This showed a reduction in the number of radiological investigations (USS, CT, MRI and sestamibi scans) done in patients with primary hyperparathyroidism following introduction of this protocol.
The aim of this audit was to compare the cost of investigating those prior to implementing the protocol, to the cost afterward.
47 cases of confirmed primary hyperparathyroidism were reviewed; 22 of those before the protocol introduction (December 2008), 25 after. We liaised with our local radiology department, and they were able to give us costings (including personnel, equipment use and ancillary costs i.e. contrast media) for each of the investigations utilised in the pre-operative assessment of these patients. An USS neck was found to cost £54.93, CT neck - £160, MR neck £368.73 and sestamibi scan £400.00. By calculating the number of investigations eliminated via the protocol, we used this and the costings to derive a figure for the savings.
Prior to the introduction of the protocol, five patients who were not considered for parathyroidectomy had imaging studies, comprising three ultrasound scans, four sestamibi scans, one CT and one MRI scan; a total cost of £2294.34. Since the protocol has been in use, two patients who have not been referred for surgery have had localisation scans – two ultrasounds and one sestamibi scan – total cost of £509.86.
Introduction of a protocol to rationalise radiological investigation of PHP resulted in a saving of £1784.48 by reducing the number of inappropriate investigations.
DOI: 10.1530/endoabs.31.P23
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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