RESUMO
Objective: This study aims to evaluate and compare computed tomography (CT)-contrast operational workflow and hospital imaging efficiency when using a multi-dose bulk IV contrast delivery system and when using a single-dose packaging contrast. Materials and Methods: A multi-center prospective observational study was conducted in six regions in China. The operating time and workflow of radiology nursing staff were evaluated and observed using an investigational tool and recorded by the investigators using a stopwatch. Nursing staff's knowledge and the imaging capabilities of hospitals were collected using a questionnaire. Rate, t-test, χ 2 test, and partial correlation analysis were used to describe the knowledge of nursing staff. The operation time and frequency of the two contrast agent packages were further compared using the Stata 15.0 software. Results: A total of 42 radiology nurses and 1,167 CT contrast-operating procedures in six provinces in China were evaluated. The total operating times for the 100 ml contrast agent versus the 200 ml contrast agent were 80.67 s and 63.81 s, respectively (P < 0.01). According to the average annual hospital CT scans (49,807 scans) and the power injector (PI) market share, approximately 233 h yearly could be saved in a hospital. Regarding CT contrast knowledge, approximately 57.14% nurses expressed their willingness to use multi-dose packaging contrast agents. Conclusion: Through difference and correlation analysis on real-world data, this study suggests that, considering safety, the use of a multi-dose bulk IV contrast agent is more time-saving and efficient for Chinese nurses and medical institutions compared with that of a single-dose package.
RESUMO
OBJECTIVE. Utilization and waste in diagnostic imaging have substantially increased worldwide. The purpose of this study was to highlight the utilization of contrast material and cost savings resulting from implementation of a multidose bulk IV contrast delivery system. MATERIALS AND METHODS. An observational study was conducted in October-November 2018 in eight hospitals in eight provinces in China. Contrast media specifications were 100-mL single-use IV contrast vials and 200-mL and 500-mL bulk packaging. Linear regression analysis was performed to identify the factors influencing contrast media use. Cost-minimization and sensitivity analyses were performed from patient and payer perspectives. RESULTS. A total of 1032 patients, some of whom underwent more than one CT examination, were enrolled in this study (100-mL package, 776 CT examinations; 200-mL package, 382 CT examinations). The mean injected volume of contrast medium was 75.46 mL. Number of scanned body parts, specification of amount of contrast medium (0, 100 mL; 1, 200 mL), whether the examination was CT angiography (CTA) (0, not CTA; 1, CTA), and patient weight all had a positive impact on the injected volume of contrast medium (p < 0.001 for all variables). Implementation of a multidose bulk IV contrast delivery system combined with different reimbursement units resulted in substantial waste reduction, estimated at US$5.59-6.04 per contrast-enhanced CT examination from the payer perspective, US$12.84-14.66 per examination from the patient perspective, and a total reduction of US$18.29-20.70 per examination. CONCLUSION. Use of multidose packaging of contrast media combined with reimbursement units for patients undergoing IV contrast-enhanced CT was found to be cost saving compared with use of single-dose packaging.
