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It is obvious that any discussion of the cost of providing a radiology service must of necessity include figures that may be outdated quickly. Many of the costs listed represent averages and vary, depending on supplier and region of the country. Costs are based on the purchase of new items. These can be lowered significantly by searching for used equipment. Operating costs and building costs differ with locality.
The purpose of this section is not so much to tell you the exact cost of each item in the list, but has greater value in reminding you of the comparative role that each of the separate items plays in determining the total cost of operating your radiology service.
The discussion of costs of a radiology service is based on a small animal operation. The costs of the x-ray machine and processor as well as the building costs are different for the equine practitioner using a portable x-ray unit. Use the parts of the work sheet that are applicable in determining your costs.
The following material has been compiled from informal discussions with those who generate a significant amount of their professional income from radiology. The dollar values are felt to be realistic today and are offered so that it is possible to begin to appreciate how the cost of a radiographic examination is determined. The prices given are for new equipment delivered and installed. Used equipment is available but bear in mind that it is often physically larger, may have specific electrical requirements and, in general, is expensive to move, install, and service. An individual who is mechanically and electronically inclined and likes bargain hunting may easily cut the investment by 50%, but remember these efforts and skills when computing your costs.
The cost of the basic equipment is depreciated over a 10-year period and this cost added to the cost of space required in the clinic or hospital to house the radiology facility. This cost is determined to be $38.41 per day. Fixed operating costs include utilities, building maintenance, equipment maintenance, and film badge service. Equipment maintenance is highly variable. Current maintenance contracts on new equipment are approximately 12% of the cost of the equipment per year and probably provide a type of service that exceeds that required by the average clinic or hospital. The total fixed daily cost is $48.36.
Examination costs are based on a 20-minute examination time and assume that two people plus the owner are required to produce the study. A "professional fee" of $10.00 may be inadequate or excessive, depending on the skill of the veterinarian. It is included primarily to point out that this part of the fee must be considered or it will be lost entirely.
A cost accounting analysis based on cost per single film has been recently published (Wilson, 1983).
The cost of radiographic film makes a careful examination of the problem of ''retakes" a necessity. Random sampling of unsatisfactory radiographs suggests that 30% of the films are underexposed, 40% are overexposed, 16% are improperly positioned, 4% show motion, and 4% have film fogging of some type. A film counting system that evaluates unsatisfactory films is not difficult to establish and requires little time once the system is developed. Films should be divided into the following categories:
It is not difficult to determine the cost to your practice if you are having to retake a significant number of radiographs. The value of a system to evaluate the causes of unsatisfactory results can easily pay for itself. Assuming a ''retake" level at 25%, which is probably a near accurate figure for most clinics, and an examination rate of 10 examinations per day, it is easy to see that you are throwing away 10 films/day which totals around $5,000 .00 per year. (If you save the film for silver recovery you will recover a part of this loss.)
Another way to lower the cost of a radiographic study is to consider a lease arrangement.
Leasing programs are becoming attractive because of the advantage of not having to invest capital into the equipment. These plans can combine lease-purchase options or may be just lease programs. Costs of these types of programs at the time of writing would be approximately:
There is often a minimum purchase requirement ($500-$1,000). Some plans permit you to purchase the equipment at a low cost (10% ) at the end of the plan. A big advantage is that your payments are tax deductible on a monthly basis.
Companies have recently offered programs through which it is possible to more easily convert to rare earth imaging systems. The screens are made available on a leasing program that includes installation of the screens or screens mounted in cassettes. Screens and cassettes may be repaired if performance is impaired by normal wear and tear. The plan may vary dependent on the length of time of the lease and may be influenced by your agreeing to use x-ray film furnished by the leasing company. Some plans may permit you to convert yearly and take advantage of new screen technology at no extra cost. The price of the lease arrangement may be fixed for as long as you choose to renew the lease thus providing some protection from increases in price of the screens or the cassettes.
*(assume 264 working days per year)
*(assume 22 working days per month)
Number of examinations/business day
5 -------------10 ---------------20 -----------30
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