| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 92 === Presently in Taiwan, most research papers regarding the cost effectiveness of establishing PACS have focused primarily on the technical field and establishment reports from major hospital’s information departments. As such, they have failed to conduct in-depth analysis from a cost effective perspective and by applying mathematical methods. Therefore, the purpose of this paper is to deconstruct the costs of establishing PACS, to compare the cost differences between PACS and traditional film system, and to consider when the total costs of these two systems will equal. In addition, this paper aims at measuring and evaluating changes in effectiveness regarding medical services, education, and case research before and after PACS are established.
Applying the methods of retrospective case study and questionnaire survey, this paper conducts cost benefit analysis by using data on the hospital’s management costs, equipments items, image examination volume, manpower and space etc. and the effectiveness data was collected from the hospital’s past quality control activities and questionnaire survey. The conclusion consists of two parts, one on the result of cost analysis, the other on the effectiveness of PACS.
Supposing the discount rate is 3% and the yearly chest X-ray examination volume is 234,000 times, the yearly cost of the traditional film period equals to NTD $176,974,000 and the PACS’s first year cost equals to NTD $199,350,000 of the hospital. After implementing PACS,the fixed cost was increased by 70.4% and the variable cost was reduced by 1.4%. Supposing a constant chest X-ray examination volume to be 234,000 times per year, the average unit cost of using PACS will be NTD $95.6 less than using traditional film. If the yearly X-ray examination volume increased by a constant rate, the years required when cumulative yearly cost of PACS and traditional film equal will be shorten.
Overall, the implementation of PACS can save image operating space and manpower. Effectiveness can also be achieved in many aspects including time effectiveness, quality index effectiveness, as well as effectiveness in service, education and research. For example, the waiting time of patient was reduced from26.2 to 6.5 minutes, the re-examination rate was reduced by 35.24%, film usage and waste water production were decreased avoiding environmental contamination, radiation exposure of patients was decreased imposing less hazard to health.
Although the construction cost of PACS was high, effectiveness can be achieved in many aspects such as safety of patients, reduction of waste water and film. Furthermore, with the decrease of construction cost of PACS, more cost effectiveness will be obtained. The results and cost effectiveness analysis model in this research can served as reference material for future research on hospital management.
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