Resource Cost Analysis of Cervical Spine Trauma Radiography

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Abstract
To determine the resource costs of the technical component of cervical spine radiography in patients with trauma and the factors that drive resource costs, to provide a model for resource cost estimation, and to compare resource costs with other methods of cost estimation. Direct measurement was made of technologist labor and supply costs of a cohort of 409 consecutive patients with trauma who underwent cervical spine radiography. Probability of cervical spine injury was determined by reviewing emergency department medical records. An animated simulation model was used to combine cost and injury probability estimates to determine resource costs. Sensitivity analysis explored factors that determined costs and estimated uncertainty in model estimations. Comparison was made with other cost estimates. The average technical resource cost for cervical spine radiography was $49.60. Both direct labor ($19.60 vs $13.33; P <.005) and film ($8.39 vs $6.76; P <.005) costs were greater in patients with high probability of injury than in those with low probability of injury. Overall costs in patients with high probability of injury exceeded those in patients with low probability of injury by 33%. Resource costs exceeded Medicare resource-based relative value unit reimbursements for all patients with trauma. Resource costs of the technical components of cervical spine radiography varied with patient probability of injury and were higher than Medicare reimbursements.