Radiology, Vol 189, 753-757, Copyright © 1993 by Radiological Society of North America
Cost containment in the use of low-osmolar contrast agents: effect of guidelines, monitoring, and feedback mechanisms
DC Levin, GA Gardiner Jr, S Karasick, GS Shaber, RJ Wechsler, GH McArdle, CD Lockard and RJ Harford
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107.
PURPOSE: To describe a program for controlling intravenous use of low-
osmolar contrast agents (LOCAs). MATERIALS AND METHODS: The department of
radiology at the authors' institution adopted a policy of selective use of
intravenously administered LOCAs. Clinical indications for LOCA use were
specified after consultation with the administration, risk managers, legal
department, and ethics committee of the hospital. The guidelines were then
publicized throughout the department and hospital, and a contrast agent
data form was developed to collect data on all cases. Monitoring mechanisms
were instituted. RESULTS: Over the next 23 months, 11,373 patients received
intravenous iodinated contrast agents, of whom 28.1% were deemed to be at
high risk and were given LOCAs. Monthly tracking showed no evidence of a
trend toward increasing use of LOCAs. CONCLUSION: Clear definition of use
guidelines, close monitoring, and feedback can stabilize LOCA use at
acceptably low levels.
