Abstracts

Rationale: Rapidly obtained accurate electroencephalography (EEG) is in demand in the hospital setting, but requires dedicated technologists, equipment, and space. We sought to model the annual expenditure of maintaining such a service relative to an overtime home-call technologist pool and the annualized production function of cost per EEG, and cost per minute saved per EEG.

Methods: We modeled the costs of a 24-hour EEG service based on three categories of expense: labor of technologists, equipment costs, and space costs. All costs were taken from the facility perspective and modeled on a one-year time horizon. We modeled two scenarios: 1) the cost of a de novo, dedicated 24 hour in-house EEG service with assumed 30-minute response time and 2) the costs of an overtime on-call service from an EEG technologist pool with assumed four hour response time. We obtained technologist labor costs from the 2018 American Society for Electrodiagnostic Technology (ASET) Salary and Benefits Annual report, with fringe benefits at 30% of salary. Space costs included in-house on-call space and EEG storage space, from FY 2019 General Services Administration leased hospital square footage estimates. Equipment costs included fixed cost of a single portable EEG machine and variable costs of disposables. All costs were inflated using the Consumer Price Index for Medical Goods and Services to 2020 levels (Bureau of Labor and Statistics).

Results: Labor costs predominated with $524,279 for four dedicated technologists in Scenario 1 and $33,648 in overtime and home call costs in Scenario 2. Labor costs accounted for 98% of total cost in Scenario 1 and 78% of total cost per EEG in Scenario 2. As a function of EEG production, the difference in cost per EEG (Scenario 1-Scenario 2) ranged from $49,645 with ten EEGs annually to $397 with 1000 inpatient EEGs performed per year. In the case of performing only 40 EEGs per year, the cost per EEG was $13,410 in Scenario 1 and $1,074 in Scenario 2. The incremental costs per minute saved per EEG at this case was $58.74 with a dedicated service.

Conclusions: The costs of a dedicated 24/7 conventional EEG service are large. The high cost of conventional EEG is mostly due to salary and benefit costs of EEG technologist labor.

Funding: Please list any funding that was received in support of this abstract.: No Funding.