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Canadian Journal of Gastroenterology - Volume 16 2002, Issue 7, Pages 473-482


Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada

McGill University Health Center, McGill University, Montreal, Quebec, Canada

Received 23 July 2001; Accepted 21 March 2002

Copyright © 2002 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


The cost of medical procedures is often unknown, but is nevertheless crucial for setting reimbursement and health care policies. The cost of an upper gastroduodenal endoscopy was investigated in ambulatory adults in a large academic hospital in the province of Quebec, from the perspective of the hospital.

An activity-based costing methodology was used to break down the procedure into a number of priory tasks, to which resources used at the department level labour, equipment, materials were allocated. The direct cost of performing an endoscopy ranged from $62 for an unsedated, unbiopsied patient to $89 for a sedated, biopsied patient. Not included in this amount were separate reimbursement fees of $15 for biopsy analysis and the $50 professional fee for the performing physician, which are charged directly to the Ministry of Health.

Incorporating overall, general hospital fixed overhead costs raises the cost of the procedure substantially, by $41, as does the use of nonreusable biopsy forceps, which adds about $63 to the total cost of the procedure.

Given the high proportion of overall, hospital-wide, overhead costs in the total cost of the procedure, allocation methods of these overhead costs in current hospital accounting systems should be improved to obtain a more precise estimate of the full cost of upper gastroduodenal endoscopy.

Autor: Ralph Crott, Nicholaos Makris, Alan Barkun, and Carlo Fallone



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