A METHODOLOGY FOR THE ECONOMIC-ASSESSMENT OF PICTURE ARCHIVING AND COMMUNICATION-SYSTEMS

Most economic studies of picture archiving and communication systems ( PACS) to date, including our own, have focused on the perspectives of the radiology department and its direct costs. However, many researche rs have suggested additional cost savings that may accrue to the medic al center as a whole through increased operational capacity, fewer los t images, rapid simultaneous access to images, and other decreases in resource utilization. We describe here an economic analysis framework we have developed to estimate these potential additional savings. Our framework is comprised of two parallel measurement methods. The first method estimates the cost of care actually delivered through online ca pture of charge entries from the hospital's billing computer and from the clinical practices' billing database. Multiple regression analyses will be used to model cost of care, length of stay, and other estimat es of resource utilization. The second method is the observational mea surement of actual resource utilization, such as technologist time, fr equency and duration of film searches, and equipment utilization rates . The costs associated with changes in resource use will be estimated using wage rates and other standard economic methods. Our working hypo thesis is that after controlling for the underlying clinical and demog raphic differences among patients, patients imaged using a PACS will h ave shorter lengths of stay, shorter exam performance times, and decre ased costs of care. We expect the results of our analysis to explain a nd resolve some of the conflicting views of the cost-effectiveness of PACS. (C) 1995 by W.B. Saunders Company