Utilization and Cost-Effectiveness of Cranial Computed Tomography at a University Hospital

Abstract

This study prospectively surveyed the utilization of cranial computed tomography (CCT) at The George Washington University Hospital over a 12-month period. Of 3,070 CCT scans studied. 1,098 (35%) resulted in a positive clinically important diagnosis for an overall case finding cost of $800. Within each of 25 individual indications for scanning, classified on the basis of the patient's most specific sign or symptom, case finding costs varied from a low of $411 for patients in coma to $3,500 for patients with headaches as their only indication for CT scanning. Within two diagnostic categories, malignant brain tumors and cerebral aneurysms, there was significant agreement (p < 0.001) between the prescanning diagnosis and the result on CCT. Overall there was also close agreement (correlation coefficient =0.706) between the rank listing of the 25 indications for scanning compiled prior to CCT with that obtained after the scanning results were known.