Cost-effectiveness Analysis of Protocol-driven Barium Enema Performed by Radiographers

Full Article

CM Chu, WH Ng, DYW Siu, WK Li, PSF Lee

Hong Kong J Radiol 2008;11:112-5

Objective: To assess the cost-effectiveness of protocol-driven barium enema performed by radiographers compared with that performed by radiologists.

Methods: This was a retrospective review of 248 consecutive patients undergoing barium enema between January 2006 and February 2008. 173 barium enemas were performed by radiographers and 75 by radiologists. The degree of colonic visualisation for each group was analysed. The screening time and total dose product (Gy/cm2) for the examination were recorded. The number of films, contrast volume, and number of staff for each group were included in the estimation of the cost of the examination.

Results: Sufficient visualisation to be of diagnostic value was achieved by 93.6% of barium enemas performed by radiographers and 100% of those performed by radiologists. There was no statistically significant difference in consumption of barium and films, screening time, and total dose product (p > 0.05). The manpower for barium enema examination decreased by 40%, the productivity increased by 67%, and the estimated cost decreased by 37% when performed by a radiographer compared with a radiologist.

Conclusions: The cost of protocol-driven barium enema performed by radiographers was significantly reduced without decreasing quality or increasing the radiation dose for patients. Protocol-driven barium enema performed by radiographers is a cost-effective method of enhancing productivity and efficiency for the radiology services.