Economic aspects of ultrasound diagnostics in gastroenterological outpatient care

Due to new examination techniques, the quality of gastroenterological ultrasound diagnostics has improved considerably in the last few years. In the long term these techniques are an indispensable requirement for competent examinations. However, the price of such high-quality apparatus has increased considerably. Aim: To ascertain the financial prerequisites for highly specialised ultrasound services in a gastroenterological out-patient department. Method: Systematic determination of costs and income from ultrasound diagnostics within the public health system for the second quarter of 2001 (KV Bayern) and precise definition of the cost of individual services. We apply the results obtained to other settings e.g. in-patient departments. Results: The use of a grade 3 ultrasound appliance (DEGUM criteria) is cost-effective on the basis of 1940 examinations per year within taking a fictitious physician's fee into account. Based on a fee of 50.00 Euros per hour, an examination frequency of 5834 per year would be required, whereas a fee of 100.00 Euros per hour could not be recovered even by an extremely large number of examinations. Conclusion: The present fee paid by the public health sector does not cover the expenses of a grade 3 ultrasound appliance. We discuss feasible solutions for offering a highly specialized, customer-friendly and cost-effective method for ultrasound examinations within the gastroenterological practice.