The results in the present study conclude that PACS was well perceived due to its numerous benefits among physicians and radiologists. However, radiologists showed more focus on the benefits of PACS than physicians. The main disadvantages are that PACS has resulted in difficulty in finding images, recurrent downtime and insufficient training.

Backgroundand Objectives: COVID-19 is a novel infectious disease caused by a single-stranded RNA coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to conduct a nationwide multicenter study to determine the characteristics and the clinical prognostic outcome of critically ill COVID-19 patients admitted to intensive care units (ICUs). Materials and Methods: This is a nationwide cohort retrospective study conducted in twenty Saudi hospitals. Results: An analysis of 1470 critically ill COVID-19 patients demonstrated that the majority of patients were male with a mean age of 55.9 ± 15.1 years. Most of our patients presented with a shortness of breath (SOB) (81.3%), followed by a fever (73.7%) and a cough (65.1%). Diabetes and hypertension were the most common comorbidities in the study (52.4% and 46.0%, respectively). Multiple complications were observed substantially more among non-survivors. The length and frequency of mechanical ventilation use were significantly greater (83%) in the non-survivors compared with the survivors (31%). The mean Sequential Organ Failure Assessment (SOFA) score was 6 ± 5. The overall mortality rate of the cohort associated with patients that had diabetes, hypertension and ischemic heart disease was 41.8%. Conclusion: Age; a pre-existing medical history of hypertension, diabetes and ischemic heart disease; smoking cigarettes; a BMI ≥ 29; a long mechanical ventilation and ICU stay; the need of ventilatory support; a high SOFA score; fungal co-infections and extracorporeal membrane oxygenation (ECMO) use were key clinical characteristics that predicted a high mortality in our population.

Spending by the UK's National Health Service (NHS) on independent healthcare treatment has been increased in recent years and is predicted to sustain its upward trend with the forecast of population growth. Some have viewed this increase as an attempt not to expand the patients' choices but to privatize public healthcare. This debate poses a social dilemma whether the NHS should stop cooperating with Private providers. This paper contributes to healthcare economic modelling by investigating the evolution of cooperation among three proposed populations: Public Healthcare Providers, Private Healthcare Providers and Patients. The Patient population is included as a main player in the decision-making process by expanding patient's choices of treatment. We develop a generic basic model that measures the cost of healthcare provision based on given parameters, such as NHS and private healthcare providers' cost of investments in both sectors, cost of treatments and gained benefits. A patient's costly punishment is introduced as a mechanism to enhance cooperation among the three populations. Our findings show that cooperation can be improved with the introduction of punishment (patient's punishment) against defecting providers. Although punishment increases cooperation, it is very costly considering the small improvement in cooperation in comparison to the basic model.

Few modelling studies have been carried out to investigate patients' involvement in the decision-making process in a healthcare system. Here we perform theoretical and simulation analysis of a healthcare business model involving three populations: Public Healthcare Providers, Private Healthcare Providers and Patients. The analysis contributes to healthcare economic modelling by analyzing the dynamics and emergence of cooperative behavior of agents within the three populations. Resorting to agent-based simulations, we examine the effect of increasing behavioural mutation and providers' capacity on patients' cooperative behaviour. We show that the former introduces more randomness in agents' behaviors enabling cooperation to emerge in more difficult conditions. Moreover, when the providers' capacity to meet patients' demand is limited, patients exhibit low levels of cooperation, implying a more difficult cooperation dilemma in a healthcare system that needs addressing.