Características da demanda por tomografia computadorizada crânio-encefálica motivos e custos dos exames

It was reviewed a series of 2860 cerebral computed tomography (CCT) in order to compare the main reasons at referral to investigation with the CCT results and the costs with normal and abnormal CCT. It was also studied the tage and sex of the patients. Data were collected from one out of three diagnostic centers in Salvador, Brasil, for a three years period. The 2860 CCT exclude all investigation carried out for the follow-up of a previously diagnosed abnormality. CCT abnormalities were detected in 1152 (40.3%). The following reasons showed the highest proportion of abnormal CCT, for males and females respectively: demential syndrome (91.7 and 83.3%); cerebrovascular accidents (85.1 and 73.6%); infectious and parasitary diseases (76.5 and 78.6%); tumors (65.8 and 55.4%); and head injuries, 63.6% for males. In the female group, 65.0% of the CCT were normal, in a range of 65.0 to 80.0% for the age groups under 54 years old. In the male group, the highest proportion of normal CCT was found in the age groups: 25-34 (68.4%), <15 (62.9%) and 35-44 (62.7%). The most common reasons for normal CCT for males and females were: headache (81.3 and 87.5%); dizziness/vertigo (79.3 and 78.6%); seizures (67.3 and 70,0%); psychomotor deficiency (72.0 and 67.7%) and «endocrine disorders», 75.0% for each sex. The highest proportion of normal CCT (65.3%) was requested by medical «convenios». The cost with normal CCT reached US$ 565,225 and with the abnormal ones, US$ 381,247. Costs with normal CCT were 2.2 higher for medical «convenios» as compared to those of the National Institute of Security requests and 2.8 more than those of private medicine.