South Korean hospitals find that PACS pays

A survey of every hospital in South Korea found that revenues from both inpatient and outpatient radiology departments were significantly higher one year after the introduction of PACS.

The authors analyzed inpatient and outpatient revenue data of all 212 general hospitals in South Korea obtained from the Korean National Health Insurance Corporation (KNHIC) over a four-year period. An exclusive socialized national healthcare insurance system covers all Korean citizens - private health insurance is not allowed by law. The study appears in the Journal of Digital Imaging (2002 Dec 20 [epub ahead of print]).

"The primary strength of our study is the accuracy of each hospital's actual revenue, in that all general hospitals in Korea were included," said Dr. Woong-Sub Park, an assistant professor of preventive medicine and public health at the College of Medicine of Kwandong University. "KNHIC pays all medical insurance claims submitted by all hospitals. Therefore, the data obtained from KNHIC for our study were the actual payments to general hospitals during the period from 1996 through 1999."

The authors allowed a one-year time lag between the implementation of PACS and the collection of revenue data in order to obtain a truer temporal relationship between the two. The study analyzed the effects of PACS on outpatient and inpatient revenue, since content, process, case mix, and the copayment rates of inpatient care differ from those of outpatient care, Park said.

A number of variables were considered in the analysis:

?status of PACS implementation
?population size
?state of competition
?hospital location and size
?hospital status as tertiary, public, or private

"Although the causality needs to be clarified, the implementation of PACS was significantly correlated to the increased amount of inpatient and outpatient revenue, while controlling for various confounding variables," Park said.

The study also found that the number of patients were statistically significantly higher one year after introduction PACS.

"As described in previous studies, PACS not only improves staff satisfaction and quality of service and increases staff productivity, it can also lead to increased numbers of patients, which in turn can lead to increased hospital revenue," Park said.

Park cautioned that comprehensive economic feasibility could not be determined, since the cost of implementing PACS was not considered in the study.

Also, various biases may exist in the study.

"For example, there is possibility that PACS was introduced in hospitals that anticipated an increase in revenue," he said.