title: Assessing the performance of imaging health systems in five selected hospitals in Uganda.
abstract: OBJECTIVE
  The first objective of the study was to develop an index termed as the 'Imaging Coverage' (IC), for measuring the performance of the imaging health systems. This index together with the Hospital-Based Utilization (HBU) would then be calculated for five Ugandan hospitals. Second, was to relate the financial resources and existing health policy to the performance of the imaging systems.
  
  
  METHODS
  This was a cross-sectional survey employing the triangulation methodology, conducted in Mulago National Referral Hospital. The qualitative study used cluster sampling, in-depth interviews, focus group discussions, and self-administered questionnaires to explore the non-measurable aspects of the imaging systems' performances.
  
  
  RESULTS
  The IC developed and tested as an index for the imaging system's performance was 36%. General X-rays had the best IC followed by ultrasound. The Hospital-Based Utilization for the five selected hospitals was 186 per thousand and was the highest for general radiography followed by ultrasound.
  
  
  CONCLUSIONS
  The IC for the five selected hospitals was 36% and the HBU was 186 per thousand, reflecting low performance levels, largely attributable to inadequate funding. There were shortfalls in imaging requisitions and inefficiencies in the imaging systems, financing, and health policy. Although the proportion of inappropriate imaging was small, reducing this inappropriateness even further would lead to a significant total saving, which could be channeled into investigating more patients. Financial resources stood out as the major limitation in attaining the desired performance and there is a need to increase budget funding so as to improve the performance of the imaging health systems.
authors.affiliation: Department of Radiology, Ernest Cook Ultrasound Research and Education Institute, Kampala, Uganda.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Kawooya
authors.forename: George
authors.initials: G
authors.lastname: Pariyo
authors.forename: Elsie Kiguli
authors.initials: EK
authors.lastname: Malwadde
authors.forename: Rosemary
authors.initials: R
authors.lastname: Byanyima
authors.forename: Harriet
authors.initials: H
authors.lastname: Kisembo