Abstract
Computed Tomography (CT scan) the Value and Impact on the Patient's Management & Health Care Providers in the MoPH Hospitals Cost-effectiveness of conventional CT compared to spiral CT scanning was study in three MOPH hospitals, one in Bangkok (spiral CT), the other two in the central (conventional CT) and southern (spiral CT) parts of Thailand during 6-month period in 1995 - 1996.Objective: Primary : To study cost per CT examination and cost per accurate diagnosis comparing between conventional and spiral CT scanners and also to study indication appropriateness for CT request among three hospitals. Secondary : To study the rate of using spiral mode and options which are specifications of spiral CT scanner differred from the conventional CT scanner. To study impact of CT request on the different fringe benefit groups of patients. Design : Prospective cross-sectional study.Participants: All CT requested patients during 6 months, 726 cases in the hospital with conventional CT, 436 and 432 cases in the other two hospitals with spiral CT.Main Outcome Measures: Cost per CT examination, cost per accurate diagnosis and percentage of appropriateness for CT request.Results: Cost per conventional CT examination is 2,928 Bht. while cost per accurate diagnosis is 3,068 Bht. Cost per spiral CT examination in BKK. = 6,344 Bht. and in the hospital outside BKK. = 3,738 Bht. while the cost per accurate diagnosis = 6,554 Bht. and 4,027 Bht. respectively. The accuracies in diagnosis are almost the same, i.e., 95% for conventional CT 97%, and 93% for spiral CT with almost perfect inter-observer reliability (K = 0. 8 - 1) and 92 - 95% agreement of the abnormal findings. The study shows tendency of some influence on decision of CT request for government officials whom full reimbursement is applicable. The appropriateness of CT request is 92% in the conventional CT; 70%, and 75% in the other two hospitals of spiral CT. Conclusion: Conventional CT is more cost-effective than spiral CT in the MOPH hospitals. The accuracies in diagnosis are not different.
