Background: The rapid development of endoscopic technologies over the past decade has led to an increased utilization of resource-intensive endoscopic procedures in clinical practice. These procedures are technically challenging, time consuming, and typically involve major equipment-related costs.
Objective: To determine the economics associated with performing resource-intensive endoscopic procedures in a tertiary-referral center
Design: A retrospective practice database review.
Setting: A single, North American tertiary-referral medical center.
Patients: All the patients whose initial contacts with the medical center were as outpatients for an EUS, EMR, or ERCP between July and November 2004.
Main outcome measurements: Hospital charges, the cost of providing services, revenue, and net income from all services provided through June 2006.
Results: Seventy patients were tracked. During the review period, these 70 patients generated a total of $2.9 million, or $42,126 per patient, in hospital charges. The net profit was $407,263 ($5790 per patient). Endoscopic services alone resulted in a loss of $424 per patient. Surgical services generated just over $300,000 in net profit.
Conclusions: Economics for only resource-intensive endoscopic procedures are not financially viable under the current health care reimbursement system. The first step to removing disincentives to performing these cost-effective procedures would appear to be an insistence that reimbursement be weighted equitably to ensure reasonable profitability.