The impact of contracts on outsourcing computed tomography examinations from a Swedish public university hospital to a private radiology unit |
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| Affiliation: | 1. Department of Molecular Medicine and Surgery (MMK), K1, Stockholm, Sweden;2. Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden;3. Department of Radiology, Karolinska University Hospital in Solna, Stockholm, Sweden;1. Power & Industrial Systems R&D Center, Power Systems Company, Toshiba Corporation, 4-1, Ukishima-cho, Kawasaki-ku, Kawasaki 210-0862, Japan;2. Isogo Nuclear Engineering Center, Power Systems Company, Toshiba Corporation, 8, Shinsugita-cho, Isogo-ku, Yokohama 235-8523, Japan;1. GFZ German Research Centre for Geosciences, Department 1: Geodesy and Remote Sensing, Section 1.3: Earth System Modelling, Potsdam, Germany.;2. Freie Universitát Berlin, Institute of Meteorology, Berlin, Germany.;1. Departamento de Física Teórica de la Materia Condensada, Condensed Matter Physics Center (IFIMAC), Spain;2. Instituto Nicolás Cabrera, Universidad Autónoma de Madrid, E-28049 Madrid, Spain |
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| Abstract: | IntroductionAfter years of outsourcing without detailed contracts from one of Sweden's largest university hospitals to external radiology units, the hospital started to use a specific contract for outsourcing computed tomography (CT) examinations. The purpose of this study was to compare the cost-effectiveness of two outsourcing approaches, where examinations were performed either with a detailed, specific contract (with-contract) or without (no-contract), between a hospital radiology department and private external units.MethodsThis retrospective study included a group of electively outsourced CT-examinations (n = 132) and a control group of in-house CT-examinations (n = 132), selected from the three different types of CT-examinations referred from the Departments of Oncology and Hematology.These examinations were randomly selected from four different groups over two time periods of one year each, one being outsourcing without a contract (no-contract, during 2013), one time period with a specific contract (with-contract, during 2014) and two control groups of examinations performed in-house within both these time periods. We compared outsourced examinations (both no-contract and with-contract groups) and in-house examinations. The comparison of these groups include five parameters; management-time, patient waiting-time, the quality of the examinations, - image interpretations and costs.ResultsDuring 2013, management-time for CT-examinations was longer in the outsourced group (no-contract) than in the in-house group, with a statistical significance (P = 0.002). Fewer examinations performed in-house and in the with-contract group needed re-interpretation than in the no-contract group. CT-examinations in the with-contract group were associated with shorter overall management-time, patient waiting time and lower costs compared to the no-contract group.ConclusionUsing a contract with detailed specifications for outsourcing CT-examinations may be an effective way of reducing patient waiting time. Outsourcing based on a well-founded contract can be cost-effective, compared with outsourcing without a detailed plan for the services required. |
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| Keywords: | Public-private sector partnerships Outsourced services Contract services CT-examinations Cost-effective Patient waiting time |
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