Encrypted login | home

Program Information

Electron Beam Utilization in the Era of Health Care Cost Containment

I Das

I Das*, D Barbee , J Xue , N Sanfilippo , NYU Langone Medical Center, New York, NY


SU-I-GPD-P-4 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: Linear accelerators for radiation oncology are typically acquired with all available electron energies (vendor preference) rather than referral and clinical needs. Analysis of electron beam utilization in the context of machine acquisition, beam energy selection, manpower for maintenance, QA, and administrative compliance especially in cost containment of healthcare is presented.

Methods: Electron usage from an academic institution is explored derived from several years of usage data, including, photons, electrons, and disease sites. A matrix is generated for cost of acquisition (machines, phantom and QA devices), time needed for maintenance, Daily, monthly, and annual QA of multiple machines along with frequency distribution of disease sites and its associated usage of beam energies.

Results: Vendors have streamlined beam energy and created a default selection for photon and electron beams ranging from 4-21 MV and 4-22 MeV, respectively. Our data shows that 82%, and 12.4% usage is for 6MV and 15 MV beam, respectively, indicating significant wasted resources for electron beam usage. For a multi-machine department with 27% breast, 23.5% head and neck practice, electron usage over 2 years was mere 5.7%, distributed among: extremities, breast, face and head and neck keloid and trunks as 6.5%, 49.8%, 24.1%, 9.9% and 8.6%, respectively. However, for administrative compliance 2/3 of efforts is used in electron beam for maintenance and QA for <5% of the cases.

Conclusion: Electron beams used for superficial tumors result in wasted resource allocation for most radiation centers where utilization is a mere 1-5% with multiple machines. Electron energy selection should be customized based on referral pattern for clinical practices rather than vendor default. A comprehensive approach in beam utilization study, industry partnership, physicians input is needed to limit proliferation of excess electron energies and provide optimum beams for clinical usage. Not every machine should have electron options, thus saving resources.

Contact Email: