[Technical considerations of a system of phosphor digital radiography and its cost-effectiveness in a radiology...

The authors report the technical-applicative characteristics of a storage phosphor system (ADC 70, Ag-fa), experimentally used at the Department of Radiology of the University of Modena (Azienda Ospedaliera Policlinico) and analyze its effects on the center budget. The system was applied to urologic, osteoarticular and thoracic diagnoses, with bedside exams in the latter case. An automatic system (chest changer, Dupont) was used for hospitalized walking patients and for nonhospitalized patients. The data relative to the consumption of films and chemical products and the relative cost were analyzed and It. L. 84,284,782 appeared to have been saved on the annual budget. The data extrapolated from the practical experience of the Modena Radiology Department showed an average 900 exams a month, with 2,019 films being used for conventional radiography versus 918 with the ADC system. Reusing the same evaluation system, the implementation of the same system was simulated in another hospital with different characteristics (Azienda USL Imola, Bologna). The final result was an estimated annual saving of about It L. 83,000,000. The total workload of X-ray rooms afferent to the developing ADC system was considered for both departments and the cost of the conventional system compared with that of the digital system with laser print: about 197 square meters of film were used monthly with the conventional system, versus 55 after the implementation of the ADC system. The estimated figures were about 424 versus 235 for the implementation of the same ADC system in the second hospital. 9-10% was the estimated saving of the ADC system versus the conventional one thanks to fewer of the so-called refuses-i.e., exams that must be repeated; 63-81% chemical products were also saved because fewer films were developed. The cost-effectiveness of the ADC system in the budget of the two centers is stressed, with about 40% total saving. In particular, using the transfer price system for intermediate departments by Regione Emilia Romagna, the annual full cost per exam (weight = 1) decreased from It. L. 4,343 to It. L. 4,120 before and after the ADC system implementation, respectively.