Comparative assessment of digital and analog radiography: diagnostic accuracy, cost analysis and quality of care.
OBJECTIVE
The aim of this study was to compare digital and conventional radiography for diagnostic accuracy, direct costs, and quality of care.


METHODS
Diagnostic accuracy was assessed by a critical review of the literature on sensitivity, specificity and ROC analysis of these imaging techniques and by a survey with a panel of radiologists. Direct costs and quality of care were evaluated with a before/after study of the implementation of digital radiography in a Department of Radiology in 'Hospices Civils de Lyon' (France). We included 292 patients and measured duration of examinations and direct costs of equipment, films, maintenance and depreciation. To evaluate any changes in working conditions and patient management, a questionnaire was filled out by the staff of the department.


RESULTS
Diagnostic accuracy with digital radiography was equivalent to that of conventional radiography but there were wide variations depending on the type of examination. In 1993, although digital radiography resulted in savings of FF 18,000 including tax (US$ 3600) on film consumption for 1 year of examinations, there was a global additional cost of FF 253,000 (US$ 50,600) for maintenance and depreciation. Results showed a nonsignificant tendency to reduced procedure times for all examinations. Working conditions improved, including greater availability for the patient, improved safety, and increased job interest.


CONCLUSIONS
Digital radiography can be introduced into a large hospital to improve patient and staff conditions, at a higher cost than analog radiography, and depending on the type of examinations performed by the radiology department.
Colin
C
C
Département d'Information Médicale des Hospices Civils de Lyon, Hotel Dieu, France. COLIN@RECIF.UNIV-LYON1.FR
Vergnon
P
P
Guibaud
L
L
Borson
O
O
Pinaudeau
D
D
Perret Du Cray
M H
MH
Pasquier
J M
JM
Tran-Minh
V
V
D017046:Cost Savings; D005260:Female; D005602:France; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000191:economics / Q000592:standards; D011859:Radiography / Q000191:economics / Q000592:standards; D011872:Radiology Department, Hospital / Q000191:economics* / Q000592:standards*; D012680:Sensitivity and Specificity; D013997:Time Factors; D014963:X-Ray Intensifying Screens