Original Research

Cost analysis of violence-related medical imaging in a Free State tertiary trauma unit

Tiaan P. Steyn, Fekade A. Gebremariam
South African Journal of Radiology | Vol 23, No 1 | a1664 | DOI: https://doi.org/10.4102/sajr.v23i1.1664 | © 2019 Tiaan P. Steyn, Fekade A. Gebremariam | This work is licensed under CC Attribution 4.0
Submitted: 15 September 2018 | Published: 08 January 2019

About the author(s)

Tiaan P. Steyn, Department of Clinical Imaging Sciences, Universitas Academic Hospital, University of the Free State, South Africa
Fekade A. Gebremariam, Department of Clinical Imaging Sciences, Universitas Academic Hospital, University of the Free State, South Africa

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Background: Violence is a leading public health problem worldwide. Beyond the pain and suffering, violence has a significant economic impact on a country’s health, policing and judicial services. Because of the lack of current and comprehensive data in South Africa, local violence-related economic impact studies are largely estimations. Violence-related imaging expenditure, as a component of a public hospital’s expenditure, is yet to be determined.

Objectives: The goals of this study were to measure the violence-related patient burden on Pelonomi Tertiary Hospital’s (PTH) trauma and radiology services, determine the imaging-component cost of violence-related injuries and calculate the financial burden violence has on the hospital’s expenditures.

Method: From the PTH’s trauma unit patient registry, 1380 patients with violence-related injuries were consecutively sampled for 6 months ending 31 December 2017. Imaging investigations were documented and categorised according to the South African National Department of Health’s 2017 Uniform Patient Fee Schedule (UPFS). Descriptive analysis and cost calculations were performed using the 2017 UPFS tariff schedule and hospital-specific health efficiency indicators – patient-day equivalent and expenditure per patient-day equivalent.

Results: Violence-related injuries accounted for 50.64% of all trauma department visits and received a total of 5475 imaging investigations. Violence-related imaging investigations represented 14.81% of all investigations performed by the radiology department in the study period. Overall violence-related admission costs amounted to R35 410 241.85 (8.33% of the hospital’s total expenditure), of which 20.08% (R7 108 845.00) was attributed to imaging investigations.

Conclusion: Violence-related admissions had a high patient and financial burden on PTH. The pinnacle of healthcare cost saving is violence prevention; however, the cost-conscious radiologist could assist with cost saving if responsible and ethical imaging practices are followed.


violence; trauma; imaging; radiology; expenditure; cost analysis


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Crossref Citations

1. Imaging findings of penetrating spinal cord injuries secondary to stab wounds on magnetic resonance imaging in a tertiary trauma unit, South Africa
Jacolien M. Rall, Fekade A. Gebremariam, Gina Joubert
South African Journal of Radiology  vol: 23  issue: 1  year: 2019  
doi: 10.4102/sajr.v23i1.1761