title: Effects of outsourcing magnetic resonance examinations from a public university hospital to a private agent.
abstract: BACKGROUND
  Sometimes the measures taken to make a radiology department more effective, such as prioritizing the workload and keeping equipment running for as many hours as staffing permits, are not enough. In such cases, outsourcing radiological examinations is a potential solution for reducing waiting times.
  
  
  OBJECTIVE
  To investigate differences in waiting time, quality and costs between magnetic resonance (MR) examinations performed in a university hospital and examinations outsourced to private service.
  
  
  METHODS
  We retrospectively selected a group of consecutive, outsourced MR examinations (n=97) and a control group of in-house MR examinations, matched for type of examination. In each group there were referrals that had a specified preferred timeframe for completion. We measured the percentage of cases in which this timeframe was met and if it was not met, how many days exceeded the preferred time. In referrals without a specified preferred timeframe, we also calculated the waiting time. Quality standards were measured by the percentage of examinations that had to be re-done and re-assessed. Finally, we calculated the cumulative costs, taking into account the costs for re-doing and re-assessing examinations.
  
  
  RESULTS
  There was no statistically significant difference between the groups, in either the number of examinations that were not performed within the preferred time or the number of days that exceeded the preferred timeframe. For referrals without a preferred timeframe, the waiting time was shorter for outsourced examinations than those not outsourced. There were no differences in the number of examinations that had to be re-done, but more examinations needed to be re-assessed in the outsourced group than in the in-house group. The calculated costs for outsourced examinations were lower than the costs for internally performed examinations.
  
  
  CONCLUSIONS
  Outsourcing magnetic resonance examinations may be an effective way of reducing a radiology department's workload. Ways in which to reduce the additional costs incurred for re-assessment of outsourced examinations must be investigated further.
authors.affiliation: Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden. Parvin.tavakol@ki.se
authors.forename: Parvin
authors.initials: P
authors.lastname: Tavakol
authors.forename: Fausto
authors.initials: F
authors.lastname: Labruto
authors.forename: Lott
authors.initials: L
authors.lastname: Bergstrand
authors.forename: Lennart
authors.initials: L
authors.lastname: Blomqvist
mesh_terms: D003362:Cost-Benefit Analysis; D006779:Hospitals, Public / Q000191:economics / Q000458:organization & administration*; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000379:methods*; D020416:Outsourced Services / Q000191:economics / Q000379:methods*; D011785:Quality Assurance, Health Care; D011872:Radiology Department, Hospital / Q000191:economics / Q000458:organization & administration*; D012189:Retrospective Studies; D013997:Time Factors