News | Computed Tomography (CT) | July 25, 2017

New York Hospital Finds Significant Cost Savings With Toshiba's Aquilion One CT

Multi-year stroke study shows more than $5.4 million in cost savings and significant improvement in patient outcomes with premium area detector CT technology

New York Hospital Finds Significant Cost Savings With Toshiba's Aquilion One CT

July 25, 2017 — In five years, Kaleida Health’s Stroke Care Center (SCC) at the Gates Vascular Institute in Buffalo, N.Y., has realized more than $5.4 million in cost savings by using the Aquilion One computed tomography (CT) system from Toshiba Medical, a Canon Group company, to diagnose acute stroke. A multiyear study showed dramatic improvements in patient outcomes across a variety of resource-intensive ICD-9-CM codes, with an up-to-a-full-day reduction in patient length of stay and better discharge dispositions. These results demonstrate that with the right multidisciplinary approach and advanced imaging technology, providers can contain costs while delivering high-quality, effective care that meets the demands of the modern healthcare environment.

Over a five-year span, the SCC, a world-class neurological and stroke care center, quantified the benefits of changing its clinical pathway and leveraging Aquilion One technology in stroke diagnosis through a non-controlled study, evaluating imaging procedures, inpatient length of stay and discharge disposition. The study compared inpatient datasets from July to September 2007, prior to the Aquilion One installation, with datasets from July to September 2009 (phase one), July to September 2010 (phase two), and July to September 2011 and July to September 2012 (phase three), which utilized the Aquilion One and addressed the top three discharging ICD-9-CM codes.

During this time period, the SCC also made significant shifts in other aspects of patient care, further contributing to improved clinical outcomes. Following the relocation of the SCC
from Millard Fillmore Gates Circle Hospital to the Gates Vascular Institute, the facility consolidated its vascular services and repositioned its Aquilion One CT systems adjacent to areas of high need: the emergency department and the catheterization lab.

“This setup enables us to get patients from the door of the ER to CT imaging, and to the CTA [CT angiography] or perfusion exams they may need, within 10 minutes,” said Nelson Hopkins, M.D., SUNY distinguished professor of neurosurgery and radiology, and founder of the Gates Vascular Institute and the Jacobs Institute. “We are also the only stroke care center in the world with all of our vascular disciplines located on the same floor, which has created new synergies between clinicians and significantly improved our work flow. And by having all of our specialists in one building and standardizing all of our imaging equipment to Toshiba Medical systems, we can address virtually any patient need immediately and effectively.”

Highlights of the findings include (full data set on file):

Length-of-Stay Data

ICD-9-CM Code

2007 Inpatient Cases – Average Days Length of Stay (w/o Aquilion ONE)

2009 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE)

2010 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE)

2011 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE)

2012 Inpatient Cases – Average Days Length of Stay (w/ Aquilion ONE)

434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction

6.03

5.58

5.24

5.23

4.98

435.9 – Unspecified Transient Cerebral Ischemia

2.69

2.55

2.51

 

2.7*

 

2.9*

434.11 – Cerebral Embolism with Cerebral Infarction

7.3

7.16

6.93

6.57

5.56

*Length of stay for ICD-9-CM code 435.9 (Unspecified Transient Cerebral Ischemia) appeared to increase between 2007 and 2011, and between 2007 and 2012. This is in part attributable to correctly identified Unspecified Transient Cerebral Ischemia cases being admitted to the hospital; other, Non-Unspecified Transient Cerebral Ischemia cases would have been discharged as outpatient, thereby increasing the weight of the length of stay for the true Unspecified Transient Cerebral Ischemia cases.

Change in Discharge Disposition

ICD-9-CM Code

Change in Discharge Disposition from 2007 to 2009

Change in Discharge Disposition from 2007 to 2010

Change in Discharge Disposition from 2007 to 2011

Change in Discharge Disposition from 2007 to 2012

434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction

19.5% increase in patients discharging home

 

14.8% increase in patients discharging home

 

55.3% increase in patients discharging home

 

65.3% increase in patients discharging home

 

435.9 – Unspecified Transient Cerebral Ischemia**

76.4% increase in patients discharging to home healthcare

23.3% increase in patients discharging to home healthcare

7.1% increase in patients discharging home

 

6.9% increase in patients discharging home

 

434.11 – Cerebral Embolism with Cerebral Infarction

62.8% increase in patients discharging home

 

20% improvement in patients discharging to home

 

73.3% increase in patients discharging home

 

67% increase in patients discharging home

 

**2009–2010 data for ICD-9-CM code 435.9 reflects the increase in patients discharging to home healthcare. 2011 saw the first increase in discharge to home for ICD-9-CM code 435.9, thanks in part to the improved patient care facilitated by the Aquilion One.

Healthcare Cost Savings

ICD-9-CM Code

2009 Quarterly Total Cost Savings

2010 Quarterly Total Cost Savings

2011 Quarterly Total Cost Savings

2012 Quarterly Total Cost Savings

434.91 – Unspecified Cerebral Artery Occlusion with Cerebral Infarction

$118,367

$197,962

$180,567

$236,910

435.9 – Unspecified Transient Cerebral Ischemia

$42,742

$43,856

$44,600

$57,732

434.11 – Cerebral Embolism with Cerebral Infarction

$29,400

$86,672

$99,918

$212,172

Annualized Savings Total

$762,036

$1,313,960

$1,300,340

$2,027,256

 

For more information: www.medical.toshiba.com

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