Filmless versus film-based systems in radiographic examination costs: an activity-based costing method

Abstract

BackgroundSince the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC) method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method.MethodsWe calculated the costs of radiographic examinations for both a filmless and a film-based system, and assessed the costs or cost components by simulating radiographic examinations in a health clinic. The cost objects of the radiographic examinations included lumbar (six views), knee (three views), wrist (two views), and other. Indirect costs were allocated to cost objects using the ABC method.ResultsThe costs of a radiographic examination using a filmless system are as follows: lumbar 2,085 yen; knee 1,599 yen; wrist 1,165 yen; and other 1,641 yen. The costs for a film-based system are: lumbar 3,407 yen; knee 2,257 yen; wrist 1,602 yen; and other 2,521 yen. The primary activities were "calling patient," "explanation of scan," "take photographs," and "aftercare" for both filmless and film-based systems. The cost of these activities cost represented 36.0% of the total cost for a filmless system and 23.6% of a film-based system.ConclusionsThe costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients.

Analyses of Budget Impact Considering the Use of the Picture Archiving and Communication System

“…In the present BIA, however, we observed that the low-cost PACS is advantageous for small-scale services because it has a low impact on the budget by avoiding costs with hardware and software and having low maintenance costs. Another recent study [17] concluded that PACS, when compared with the screen/film system, has much lower costs, offering a higher effectiveness for the health system and the patients. A study from the 1990 s [18] showed a reduction in hospitalization costs associated with faster and more precise diagnostics owing to the use of PACS.…”

“…Therefore, frequent evaluations are required, always taking into account the characteristics of the health service, the user profiles, and the level of expertise of the medical staff. It is important to point out that with the current situation, the implementation of the PACS apart from generating lower costs and BI in any scenario would also result in a productivity increase of up to 200% to 300% [16][17][18]. This would obviously require the preparation of the entire team in terms, for example, of greater agility in the generation of reports and an entire infrastructure for a demand higher than previously planned, considering the associated increase in demand.…”

Comparison of the Ministry of Health’s tariffs with the cost of radiology services using the activity-based costing method

“…To decrease imaging costs, it is recommended that hospitals run a film-less system in their radiology departments. This allows better identification of costs and the reduction of the cost of services in this department ( 14 ). Some of the study’s limitations were diversity of radiology services, poor cooperation of personnel in delivering information about their activities in the departments, and also collecting and agreement on activity drivers.…”

“…Also, in another study, there was a significant difference between the average cost of medical services and their tariffs that caused losses in the departments that were studied ( 13 ). Muto concluded in his study that film-less systems were more effective than film-based systems in delivering services to patients in radiology departments ( 14 ). Nisenbaum et al calculated the cost of C.T.…”

Análise de Custo-Efetividade do uso do Sistema de Comunicação e Arquivamento de Imagens (PACS) em mamografias digitais

“…Tabela 2 -Distribuição de custos totais considerando-se 5000 exames e efetividade da realização, visualização/ interpretação de mamografias digitais na faixa etária dos 50 aos 69 anos, comparando-se o sistema PACS com uso de monitor específico e o sistema tela/filme. mamografia através de monitores de alta resolução e específicos para esse fim, proporciona o processamento de imagens, possibilitando sua aproximação e janelamento, dentre outros recursos que trazem melhora na acurácia de interpretação do exame [30,31]. Esses recursos alcançaram melhores resultados em mulheres abaixo dos 50 anos de idade [16,17,24], pois, segundo os autores mulheres mais jovens, na pré-menopausa ou no período perimenopausal apresentam tecido mamário e heterogêneo mais denso, aspectos que dificultam a visualização/interpretação de imagens mamográficas em filmes.…”