Time Tracking of Standard Ultrasound Examinations in Pediatric Hospitals and Pediatric Medical Practices – A Multicenter Study by the Pediatric Section of the German Society of Ultrasound in Medicine (DEGUM)

Abstract

Purpose Ultrasonography is the primary imaging modality in pediatrics but still lacks sufficient reimbursement in Germany. In this multicenter study, national data for the duration of standard ultrasound in pediatrics were systematically documented in order to specify the actual time required.

Materials and Methods N = 10 hospitals (N = 5 university hospitals, N = 5 non-university hospitals) and N = 3 medical practices in Germany recorded the entire process of an ultrasound examination in a special protocol developed by the Pediatric Section of the DEGUM. The duration of each of seven single steps during ultrasonography (from data input to final discussion of the results) of different organ systems was logged.

Results In total, N = 2118 examinations from different organ systems were recorded. N = 10 organ systems were examined frequently (> 30 times). The total duration of an ultrasound examination was statistically significantly longer in hospitals compared to medical practices (median (IQR) 27 min. (18–38) vs. 12 min. (9–17), p < 0.001). The “hands-on” patient time was approximately one half of the total required time in both settings (49.9 % vs. 48.9 %). Ultrasonography of the abdomen and brain lasted longer in university hospitals than in non-university hospitals (p < 0.001, and p = 0.04, respectively). Cooperation and age did not uniformly correlate with the total duration.

Conclusion This study provides novel comprehensive national data for the duration of standardized ultrasound examinations of children and adolescents in Germany. These data are essential for a further evaluation of the economic costs and should support better remuneration in the future.

Zusammenfassung

Ziele Die Sonografie ist die primäre bildgebende Diagnostik in der Pädiatrie, wird in Deutschland jedoch unzureichend vergütet. Ziel dieser multizentrischen und systematischen Erhebung von Ultraschalluntersuchungszeiten in der Pädiatrie ist die erstmalige Analyse des tatsächlichen Zeitbedarfs.

Material und Methoden N = 10 Kliniken (n = 5 Universitätskliniken, n = 5 kommunale Kliniken) und n = 3 Praxen aus Deutschland erfassten die Gesamtheit einer Ultraschalluntersuchung in einem eigens hierfür entwickelten Fragebogen der pädiatrischen Sektion der Deutschen Gesellschaft für Ultraschall in der Medizin (DEGUM). Es wurde der genaue Zeitaufwand für sieben definierte Untersuchungsschritte (von Dateneingabe bis Befundbesprechung) für verschiedene Organsysteme protokolliert.

Ergebnisse Bei insgesamt n = 2118 Kindern wurde eine Ultraschalluntersuchung eines Organsystems durchgeführt. N = 10 Organsysteme wurden häufiger als 30-mal untersucht. Die Untersuchungszeiten in Krankenhäusern waren mehr als doppelt so lange wie in der pädiatrischen Praxis (median (IQR) 27 min (18–38) vs. 12 min (9–17); p < 0,001). Die „Hands on“-Zeit am Patienten nahm jeweils fast die Hälfte der Gesamtdauer der Untersuchung in Anspruch (49,9 % vs. 48,9 %). Die Abdomen- und ZNS-Sonografie dauerte an Universitätskliniken länger als an kommunalen Kliniken (p < 0,001 und p = 0,04). Kooperation und Alter des Kindes hatten keinen einheitlichen Einfluss auf die Untersuchungszeiten.

Schlussfolgerungen Diese Studie zeigt erstmals dezidierte Daten zum zeitlichen Aufwand von Ultraschalluntersuchungen von Kindern und Jugendlichen in Deutschland. Die erhobenen Daten sind für eine reale Bewertung des Aufwands und der volkswirtschaftlichen Kosten der pädiatrischen Sonografie von elementarer Bedeutung und können in Zukunft als Grundlage für eine entsprechende Vergütung der erbrachten Leistungen dienen.

Key words

pediatrics - point of care - time tracking - cost efficacy

^* Equal authorship.

Publication History

Received: 21 May 2019

Accepted: 27 September 2019

Article published online:
24 October 2019

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