In-Chang Hwang1, Kil Won Lee2, Sang Soon Park2, Siamphone Chanthanoulay3, Malouny Sisavanh4, Virasack Rajpho5, Mijin Kim6, Somxay Billamay7, Sommanikhone Phangmanixay7, Bounleua Oudavong8. 1. Korea International Cooperation Agency (KOICA) Lao PDR Office, Vientiane, Lao Democratic People's Republic; Cardiovascular Unit, Children's Hospital, Vientiane, Lao Democratic People's Republic; Department of Radiology, Children's Hospital, Vientiane, Lao Democratic People's Republic; Cardiovascular Center & Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: inchang.hwang@gmail.com. 2. Korea International Cooperation Agency (KOICA) Lao PDR Office, Vientiane, Lao Democratic People's Republic; Department of Radiology, Children's Hospital, Vientiane, Lao Democratic People's Republic. 3. Department of Radiology, Children's Hospital, Vientiane, Lao Democratic People's Republic; Lee Jong-Wook Fellowship Program, JW LEE Center for Global Medicine, Seoul National University & Korea Foundation for International Healthcare (KOFIH), Seoul, Republic of Korea; Department of Pediatrics, Children's Hospital, Vientiane, Lao Democratic People's Republic. 4. Cardiovascular Unit, Children's Hospital, Vientiane, Lao Democratic People's Republic; Lee Jong-Wook Fellowship Program, JW LEE Center for Global Medicine, Seoul National University & Korea Foundation for International Healthcare (KOFIH), Seoul, Republic of Korea; Department of Pediatrics, Children's Hospital, Vientiane, Lao Democratic People's Republic. 5. Department of Radiology, Children's Hospital, Vientiane, Lao Democratic People's Republic; University of Health Sciences, Lao Democratic People's Republic. 6. Korea International Cooperation Agency (KOICA) Lao PDR Office, Vientiane, Lao Democratic People's Republic. 7. Department of Pediatrics, Children's Hospital, Vientiane, Lao Democratic People's Republic. 8. Department of Pediatrics, Children's Hospital, Vientiane, Lao Democratic People's Republic; University of Health Sciences, Lao Democratic People's Republic.
Abstract
BACKGROUND: Implementation of the Picture Archiving and Communication System (PACS) is more challenging in developing countries than in developed countries. Given that the first PACS in Lao People's Democratic Republic (PDR) was successfully installed at the Children's Hospital of Lao PDR, we aimed to investigate whether the utilization rate of imaging tests increased after PACS implementation. METHODS: PACS was implemented at the Children's Hospital of Lao PDR in December 2014. We compared the utilization rates of imaging tests including X-ray and ultrasound examinations between the pre-PACS period (from December 2013 to November 2014) and the post-PACS period (from December 2014 to November 2015). The utilization rate was defined as the number of imaging tests divided by the number of patients per month. RESULTS: The average number of total imaging tests was 225.8/month (standard deviation [SD], 37.7) during the 1-year pre-PACS period and was 269.4/month (SD, 38.5) during the 1-year post-PACS period (P=0.0103). The utilization rate of total imaging tests significantly increased after PACS implementation (pre-PACS, 2.47%/month; post-PACS, 4.23%/month; P<0.0001). Increased utilization rates were observed for both X-rays (pre-PACS, 1.65%/month; post-PACS, 2.38%/month; P=0.0004) and ultrasound examinations (pre-PACS, 0.82%/month; post-PACS, 1.85%/month; P=0.0001). CONCLUSIONS: The implementation of PACS at the Children's Hospital of Lao PDR resulted in a significant increase in the utilization rate of imaging tests, suggesting the indirect benefit of improved quality of care. Our findings showed that the benefits of PACS can be realized even in a resource-limited country such as Lao PDR.
BACKGROUND: Implementation of the Picture Archiving and Communication System (PACS) is more challenging in developing countries than in developed countries. Given that the first PACS in LaoPeople's Democratic Republic (PDR) was successfully installed at the Children's Hospital of Lao PDR, we aimed to investigate whether the utilization rate of imaging tests increased after PACS implementation. METHODS: PACS was implemented at the Children's Hospital of Lao PDR in December 2014. We compared the utilization rates of imaging tests including X-ray and ultrasound examinations between the pre-PACS period (from December 2013 to November 2014) and the post-PACS period (from December 2014 to November 2015). The utilization rate was defined as the number of imaging tests divided by the number of patients per month. RESULTS: The average number of total imaging tests was 225.8/month (standard deviation [SD], 37.7) during the 1-year pre-PACS period and was 269.4/month (SD, 38.5) during the 1-year post-PACS period (P=0.0103). The utilization rate of total imaging tests significantly increased after PACS implementation (pre-PACS, 2.47%/month; post-PACS, 4.23%/month; P<0.0001). Increased utilization rates were observed for both X-rays (pre-PACS, 1.65%/month; post-PACS, 2.38%/month; P=0.0004) and ultrasound examinations (pre-PACS, 0.82%/month; post-PACS, 1.85%/month; P=0.0001). CONCLUSIONS: The implementation of PACS at the Children's Hospital of Lao PDR resulted in a significant increase in the utilization rate of imaging tests, suggesting the indirect benefit of improved quality of care. Our findings showed that the benefits of PACS can be realized even in a resource-limited country such as Lao PDR.