Tavakol Parvin, Labruto Fausto, Bergstrand Lott, Blomqvist Lennart
Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden.
Acta Radiol. 2011 Feb 1;52(1):81-5. doi: 10.1258/ar.2010.090320.
Sometimes the measures taken to make a radiology department more effective, such as prioritizing the workload and keeping equipment running for as many hours as staffing permits, are not enough. In such cases, outsourcing radiological examinations is a potential solution for reducing waiting times.
To investigate differences in waiting time, quality and costs between magnetic resonance (MR) examinations performed in a university hospital and examinations outsourced to private service.
We retrospectively selected a group of consecutive, outsourced MR examinations (n=97) and a control group of in-house MR examinations, matched for type of examination. In each group there were referrals that had a specified preferred timeframe for completion. We measured the percentage of cases in which this timeframe was met and if it was not met, how many days exceeded the preferred time. In referrals without a specified preferred timeframe, we also calculated the waiting time. Quality standards were measured by the percentage of examinations that had to be re-done and re-assessed. Finally, we calculated the cumulative costs, taking into account the costs for re-doing and re-assessing examinations.
There was no statistically significant difference between the groups, in either the number of examinations that were not performed within the preferred time or the number of days that exceeded the preferred timeframe. For referrals without a preferred timeframe, the waiting time was shorter for outsourced examinations than those not outsourced. There were no differences in the number of examinations that had to be re-done, but more examinations needed to be re-assessed in the outsourced group than in the in-house group. The calculated costs for outsourced examinations were lower than the costs for internally performed examinations.
Outsourcing magnetic resonance examinations may be an effective way of reducing a radiology department's workload. Ways in which to reduce the additional costs incurred for re-assessment of outsourced examinations must be investigated further.
有时，为提高放射科效率所采取的措施，如合理安排工作量以及在人员允许的情况下尽可能延长设备运行时间，并不足够。在这种情况下，将放射检查外包是减少等待时间的一个潜在解决方案。
研究在大学医院进行的磁共振（MR）检查与外包给私人服务机构的检查在等待时间、质量和成本方面的差异。
我们回顾性地选取了一组连续的外包MR检查病例（n = 97）以及一组内部MR检查的对照组，两组检查类型相匹配。每组中都有指定了完成检查的优先时间范围的转诊病例。我们测量了在优先时间范围内完成检查的病例百分比，如果未达到该时间范围，则测量超出优先时间的天数。对于没有指定优先时间范围的转诊病例，我们也计算了等待时间。质量标准通过必须重新进行和重新评估的检查百分比来衡量。最后，我们计算了累计成本，同时考虑了重新进行和重新评估检查的成本。
在优先时间内未完成检查的数量或超出优先时间范围的天数方面，两组之间没有统计学上的显著差异。对于没有优先时间范围的转诊病例，外包检查的等待时间比未外包的检查短。在必须重新进行的检查数量上没有差异，但外包组中需要重新评估的检查比内部组更多。计算得出的外包检查成本低于内部进行检查的成本。
外包磁共振检查可能是减轻放射科工作量的有效方法。必须进一步研究如何降低外包检查重新评估所产生的额外成本。
