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Table 1 Average cost of diagnostic exams per patient with syncope

From: Financial impact of adopting implantable loop recorder diagnostic for unexplained syncope compared with conventional diagnostic pathway in Portugal

Investigations [21]

Unit prices

Sousa Pedro [24]

Edvardsson [21]

Baron-Esquivias [7]

Brignole [4]

Farwell [16]

Unit prices reference [25]

Percentage of patients

Weighted value

Percentage of patients

Weighted value

Percentage of patients

Weighted value

Percentage of patients

Weighted value

Percentage of patients

Weighted value

 

Standard electrocardiogram

6.50€

100%

6.50€

98%

6.37€

95,6%

6.21€

100%

6.50€

-

-

Code 40301

Echocardiography

53.20€

72.2%

38.41€

86%

45.75€

2,1%

1.12€

16%

8.51€

15.31%

8.14€

Code 40550

Overload echocardiography

85.30€

1.60%

1.36€

 

-

-

-

 

-

 

-

Code 40550;40315

Abdominal echography

20.12€

-

-

-

-

-

-

2%

0.40€

-

-

Code 17130

Basic laboratory tests

 

-

-

      

-

-

Pack Estimationa

With/enzymes tests

65.87€

  

86%

56.65€

  

35%

23.05€

 

Without enzymes tests

53.87€

    

70,2%

37.82€

   

Enzymesb

34.40€

-

-

-

-

30,2%

10.39€

-

-

-

-

Pack Estimationb

Ambulatory ECG monitoring

43.70€

-

-

67%

29.28€

-

-

  

11.22%

4.91€

Code 40405

ELR

47.30€

-

-

-

-

-

-

-

-

28.57%

13.51€

 

In-Hospital ECG monitoring

124.70€

61.20%

76.32€

55%

68.59€

17,1%

21.32€

11%

13.72€

-

-

Code 40495 + daily admission (85€)

Exercise testing

32.10€

19.60%

6.29€

52%

16.69€

-

-

3%

0.96€

-

-

Code 40315

MRI or CT scan

97.45€

1.60%

1.56€

47%

45.80€

-

-

15%

14.62€

-

-

Codes 18010; 16010

MRI

127.90€

-

-

-

-

-

-

-

-

1.02%

1.31€

Code 18010

Brain CT scan

67.00€

-

-

-

-

9%

6.03€

-

-

8.16%

5.47€

Code 16010

Thorax CT scan

74.70€

-

-

-

-

1,1%

0.82€

-

-

-

-

Code 16060

Chest X-ray

9.00€

-

-

-

-

51,9%

4.67€

12%

1.08€

-

-

Code 10406

Electroencephalography

58.80€

1.20%

0.71€

39%

22.93€

-

-

6%

3.53€

2.04%

1.20€

Code 63010

Carotid sinus massage

6.50€

2.90%

0.19€

36%

2.34€

0,5%

0.03€

15%

0.98€

-

-

Code 40301

Carotid echo-doppler

23.17€

12.70%

2.94€

-

-

-

-

4%

0.93€

5.10%

1.18€

Code 17290

TILT test

124.10€

15.90%

19.73€

35%

43.44€

-

-

13%

16.13€

-

-

Code 41120

Electrophysiology testing

2,488.72€

-

-

25%

622.18€

-

-

3%

74.66€

1.02%

25.40€

Code 40950

Coronary angiography

531.44€

-

-

23%

122.23€

-

-

2%

10.63€

-

-

Code 40820

External loop recording

47.30€

11.80%

5.58€

12%

5.68€

-

-

-

-

-

-

Code 40479

Orthostatic blood pressure movements

4.00€

-

-

48%

1.92€

4,6%

0.18€

-

-

-

-

Code 99230

Hypertension map

59.20€

6.90%

4.08€

-

-

-

-

-

-

-

-

Code 41010

Neurological or psychiatric evaluation

30.90€

-

-

47%

14.52€

-

-

-

-

-

-

Code 82040

Adenosine Triphosphate (ATP) test

Not available

-

-

3%

-

-

-

-

-

-

-

Not considered

Others

-

-

-

9%

-

7,20%

-

13%

-

-

-

Not considered

Total cost

-

-

164.32€

-

1,112.02€

 

88.51€

-

173.31€

-

72.41€

 
  1. aBasic Laboratory costs were estimated considering a standard pack of analysis: Creatinine, Hemogram with leukocyte formula, urea, capillary blood glucose determination, Ionogram (Na, K, Cl), Proteins (total), Albumin Ultra-sensitive C-reactive protein, Summary analysis of Urine, acid-base balance (pH, pCO2, pO2, SatO2, CO2), D- Dimer (DD); and prothrombin time (TP, Quick, INR), (with or without: Troponin T or I, alanine aminotransferase (ALT), aspartate aminotransferase (AST)).
  2. bEnzymes tests: Troponin T or I, Creatine kinase (CK), Myoglobin (Mb), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactic dehydrogenase (LDH).
  3. Costs were taken from the Portuguese National Health Service Prices Table [25].