COST-EFFECTIVENESS OF ABDOMINAL ULTRASONOGRAPHY IN APPENDICITIS

Abstract

The objective of this study was to find out the cost-effectiveness of ultrasonographic examination in patients with lower abdominal pain to diagnose acute appendicitis. During July, 1991 to August 2000, we have performed abdominal ultrasonography in 4289 patients of lower abdominal pain by Puylaert’s graded compression technique' for acute appendicitis using Pie Medical 3.5-5 Mega-Hertz linear transducer, Aloka 210, SSD 500/1100 curvilinear probe, Fukuda 1000/3500 linear, Siemens SL 2 sector and linear probes. Among the 100 patients (M51, F49, ages 9 to 75 years) suspected of having acute appendicitis, 29 actually had appendicitis. Interpretation of appendiceal sonographic results was 98% accurate. The sonographic result led to changes in the treatment of 52 patients, and prevention of unnecessary appendectomy in 13 patients, providing a savings of about Takas 65000 ($ 1300) and prevented unnecessary hospital admission for 69 patients, thus saving approximately Tk. 7800/-. The cost of performing the 100 sonographic examinations was about Tk. 35000/- and thus the overall savings was about Tk. 500/- ($ 9.45) per patient. It is concluded that ultrasonography performed in patients with suspected acute appendicitis improves diagnostic accuracy, thus leading to more appropriate selection of patient treatment and with reduction of expenditure.