{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:47:14Z","timestamp":1777682834417,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[1999,10,1]],"date-time":"1999-10-01T00:00:00Z","timestamp":938736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Health Serv Res Policy"],"published-print":{"date-parts":[[1999,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To establish the net costs to the hospital and the broad range of benefits associated with a hospital-wide picture archiving and communication system (PACS) that comprised digital acquisition, storage and transmission of radiological images via a hospital-wide network to 150 workstations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\u2018Before and after\u2019 comparisons and time series analyses at Hammersmith Hospital (London, UK), and comparison with five other British hospitals where PACS was not being installed. The cost analysis considered implementation costs and changes in key elements of hospital running costs, including the impact of changes in the length of inpatient stays. A range of benefit measures were investigated, including image availability, avoidance of repeat imaging, avoidance of exposure to radiation, patient turn-round speed, time from examination to image availability in intensive care, avoidance of diagnostic \u2018errors' by casualty doctors, the additional diagnostic value of PACS-based images and clinician satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The annual equivalent capital cost of the PACS was \u00a31.7 million (annual equivalent replacement cost: \u00a30.8 million). Overall, the PACS substantially increased running costs. No convincing evidence of a PACS-induced change in length of inpatient stay was found. PACS was associated with some improvements in the performance of the radiology department: improved image availability (97.7% versus 86.9%), lower repeat imaging rate (7.3% versus 9.9%) and 20% lower total radiation doses for examinations of the lateral lumbar spine. No improvements were identified in the quality of the radiology reporting service. Benefits outside radiology included shorter time from examination to image availability for routine uses in intensive care (19 versus 37 minutes), and a lower rate of diagnostic \u2018errors' in casualty (0.65% versus 1.51%). High levels of satisfaction with PACS were found amongst both providers and clinical users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PACS was almost universally preferred by users and brought many operational and clinical benefits. However, these advantages came at a significant capital and net running cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/135581969900400405","type":"journal-article","created":{"date-parts":[[2017,1,17]],"date-time":"2017-01-17T22:00:12Z","timestamp":1484690412000},"page":"204-209","source":"Crossref","is-referenced-by-count":35,"title":["Evaluation of a Hospital Picture Archiving and Communication System"],"prefix":"10.1177","volume":"4","author":[{"given":"Stirling","family":"Bryan","sequence":"first","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwyn","family":"Weatherburn","sequence":"additional","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Buxton","sequence":"additional","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jess","family":"Watkins","sequence":"additional","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Keen","sequence":"additional","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Muris","sequence":"additional","affiliation":[{"name":"Health Economics Research Group, Brunel University, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1999,10,1]]},"reference":[{"key":"bibr1-135581969900400405","first-page":"894","volume":"1234","author":"Van Gennip EMSJ","year":"1990","journal-title":"Washington: SPIE"},{"key":"bibr2-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.1994.95153424"},{"key":"bibr3-135581969900400405","unstructured":"Anderson D, Flynn K. Picture archiving and communication systems: a systematic review of published studies of diagnostic accuracy, radiology work processes, outcomes of care and cost. Technology assessment program report no. 5. Boston: Veterans\u2019 Administration, 1997"},{"key":"bibr4-135581969900400405","volume-title":"Current Topics in Radiography","author":"Martin N","year":"1995"},{"key":"bibr5-135581969900400405","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.170.5.9574575"},{"key":"bibr6-135581969900400405","unstructured":"Watkins J, Bryan S, Muris N, Keen J, Buxton M. An investigation of the effect of PACS on inpatient length of stay. International Journal of Technology Assessment in Health Care 1999 (in press)"},{"key":"bibr7-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.72.858.10560334"},{"key":"bibr8-135581969900400405","doi-asserted-by":"publisher","DOI":"10.3109\/14639239709010907"},{"key":"bibr9-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.72.857.10505012"},{"key":"bibr10-135581969900400405","first-page":"635","volume":"72","author":"Weatherburn GC","year":"1999","journal-title":"British Journal of Radiology"},{"key":"bibr11-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(95)00767-9"},{"key":"bibr12-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(94)00699-F"},{"key":"bibr13-135581969900400405","doi-asserted-by":"publisher","DOI":"10.1007\/BF03168156"}],"container-title":["Journal of Health Services Research &amp; Policy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/135581969900400405","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/135581969900400405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:44:16Z","timestamp":1777452256000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/135581969900400405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1999,10]]}},"alternative-id":["10.1177\/135581969900400405"],"URL":"https:\/\/doi.org\/10.1177\/135581969900400405","relation":{},"ISSN":["1355-8196","1758-1060"],"issn-type":[{"value":"1355-8196","type":"print"},{"value":"1758-1060","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,10]]}}}