COMPARISON OF THE COSTS OF FINE-NEEDLE ASPIRATION AND OPEN SURGICAL BIOPSY AS METHODS FOR OBTAINING A PATHOLOGICAL DIAGNOSIS

Citation
Dl. Rimm et al., COMPARISON OF THE COSTS OF FINE-NEEDLE ASPIRATION AND OPEN SURGICAL BIOPSY AS METHODS FOR OBTAINING A PATHOLOGICAL DIAGNOSIS, Cancer cytopathology, 81(1), 1997, pp. 51-56
Citations number
20
Categorie Soggetti
Oncology
Journal title
Cancer cytopathology
ISSN journal
0008543X → ACNP
Volume
81
Issue
1
Year of publication
1997
Pages
51 - 56
Database
ISI
SICI code
0008-543X(1997)81:1<51:COTCOF>2.0.ZU;2-C
Abstract
BACKGROUND. A pathologic diagnosis is usually required to determine de finitive management for a palpable lesion. In this era of cost control , fine-needle aspiration (FNA) provides a low-cost alternative to open excisional biopsy. Using a broad range of cases collected over 20 yea rs, the authors of this study sought to quantify the savings resulting from the use of FNA on superficial palpable lesions to obtain a patho logic diagnosis. METHODS, 12,452 cases collected by the cytopathology service at the Medical College of Virginia during the period 1972-1991 were used to produce a profile of case type, diagnosis, and indicatio n for surgery. Charge-based cost estimations or Relative Value Units w ere calculated using the 1995 Physicians' Fee Reference or published M edicare participant fees. The charges for the FNA procedure and open s urgical biopsy were compared, and all other biopsy-related costs were omitted. RESULTS, FNA provided a sufficient pathologic diagnosis to ob viate open surgical biopsy in 63-85% of the cases. Estimation of cost savings on the basis of the distribution of cases and indications for surgery suggested a savings of $250,000 to $750,000 per 1000 FNA perfo rmed, or approximately 5500 Relative Value Units. CONCLUSIONS. This st udy quantifies the substantial savings that result from obtaining a pa thologic diagnosis by the FNA procedure rather than open surgical biop sy. (C) 1997 American Cancer Society.