Analysis of hemodynamics costs. A multicenter study based on consumed resources

INTRODUCTION AND OBJECTIVES: The main objective of this study is to know actual hemodynamic explorations costs in Spain, not only direct but total imputation costs, through a registration of duration, resources and disposables used in this minimally invasive exploration. Also to explore the variability in costs and consumptions between hospitals with similar technology in catheterization practice. METHODS: The effective duration, supplies consumptions and manpower resources utilized in 762 diagnostic catheterization, 217 therapeutic coronarographies, and 32 Inoue mitral valvotomies have been registered and analyzed in four public Spanish hospitals. The direct costs have been calculated through purchase and repair bills and officials wages. The indirect ones through repercussion judgements, and the amortization on a ten years imputation process. RESULTS: The consumption, duration and manpower data are shown with media and standard deviations. Final costs are: 106,879 pesetas for a diagnostic catheterization, 545,614 pesetas for a therapeutic coronarography, and 556,315 pesetas for a mitral Inoue valvotomy. Significative differences have been demonstrated between hospitals affecting the majority of consumption and manpower variables. There are also wide differences on indirect costs, amortization and maintenance costs. CONCLUSIONS: The catheterization costs are high in Spain mainly due to disposable material costs in spite of low manpower costs in public hospitals. The indirect administration costs are of relative importance in diagnostic catheterization, but in the therapeutic ones the only important payment are the disposable material costs who get the 85% of total cost. The differences between hospitals in durations and consumptions show the need to improve medical protocols. The differences in indirect costs reflect different steps in implementation of hospital management tools.