Cost Effectiveness

MDCTU generates a much higher patient charge than does EU. When performing MDCTU, most institutions charge for a CT of the abdomen and pelvis both without and with intravenous contrast material and then may also add an extra charge for image postprocessing. The charge for this examination is several times that of EU. Of course, the charges for a particular study do not necessarily reflect reimbursement for that study or the actual cost of performing that study. Differences in these other two areas are much less pronounced. However, by performing MDCTU instead of EU, it is likely that many possible follow-up imaging tests would no longer be needed. One study found that when EU was performed first in patients with hema-turia, additional imaging was frequently obtained (33). In comparison, when MDCTU was performed first, additional studies were eventually performed only 10% of the time. Obviously, if performing MDCTU first eliminates the need for other studies that would have been obtained after an initial EU, the overall health care cost differential for an individual may ultimately be considerably smaller than the price difference between MDCTU and EU.

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