| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 93 === ABSTRACT
PURPOSE: To determine the differential cost between film-based radiology and a whole scale hospital-wide picture archiving and communication system (PACS) set up at a municipal hospital.
MATERIALS AND METHODS: The cash flow and running costs of PACS and film-based operation were measured in an 8-year time horizon. When hospital-wide PACS was implemented in a short duration, no concomitant film output after digitization of images. The net present values (NPVs) for differences between these 2 operations were calculated to show the financial impact. Cost drives for PACS operation were also evaluated by using sensitivity analysis. The duration of return-on-investment (ROI) was measured.
RESULTS: As compared with film-based operation, there is net savings for PACS operation during the 8-year time horizon. The duration of ROI is less than 4 years. The saving is mainly from reduction in film-related variable costs. For PACS operation, the CR related devices comprise 40% of the initial capital expenditure. The incremental rate of examination number has exponential effect on the costs for film-based operation, but little effect on those for PACS operation. When there is a -6.5% annual changing rate in examination number, the NPV will become negative. When the initial capital expenditure reaches 2.2 folds of purchasing prices, the NPV will break even.
CONCLUSION: Based on our experience, properly designed PACS can produce cost saving as compared with film-based operation under NPV analysis. For hospitals with intension to go filmless, this study offers substantial evidence to support PACS implementation base on differential cost analysis.
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