Volume 6, Issue 2 (5-2022)
EBHPME 2022, 6(2): 82-89 |
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Kalantarhormozi M, Yazdanpanah A, Yazdankhahfard M, Amiri B, Nemati R, Sohrabi Shekafti M, et al . Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran. EBHPME 2022; 6 (2) :82-89
URL: http://jebhpme.ssu.ac.ir/article-1-387-en.html
URL: http://jebhpme.ssu.ac.ir/article-1-387-en.html
Mohammadreza Kalantarhormozi 
, Ahmad Yazdanpanah , Mohammadreza Yazdankhahfard , Batool Amiri , Reza Nemati , Milad Sohrabi Shekafti , Hedayat Salari , Atefe Esfandiari *
, Ahmad Yazdanpanah , Mohammadreza Yazdankhahfard , Batool Amiri , Reza Nemati , Milad Sohrabi Shekafti , Hedayat Salari , Atefe Esfandiari *
Department of Health Policy & Management, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran , Atefehesfandiari88@gmail.com
Abstract: (871 Views)
Background: The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021.
Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021.
Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value > 0.050.
Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.
Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021.
Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value > 0.050.
Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.
Type of Study: Original article |
Subject:
Health Policy
Received: 2022/03/2 | Accepted: 2022/05/20 | Published: 2022/07/3
Received: 2022/03/2 | Accepted: 2022/05/20 | Published: 2022/07/3
References
1. 1. Pennsylvania Health Care Cost Containment Council. The growth in diagnostic imaging utilization [Internet]. Available from URL: http://www.phc4.org/reports/FYI/fyi27.htm. Last access: July 10, 2007.
2. Emery DJ, Shojania KG, Forster AJ, Mojaverian N, Feasby ThE. Overuse of magnetic resonance imaging. JAMA Internal Medicine. 2013; 173(9): 823-5. [DOI:10.1001/jamainternmed. 2013.3804]
3. Herate C, Brochard P, De Vathaire F, Ricoul M, Martins B, Laurier L, et al. The effects of repeated brain MRI on chromosomal damage. European Radiology Experimental. 2022; 6: 12. [DOI:10.1186/s41747-022-00264-2]
4. Chong CD, Schwedt TJ, Hougaard A. Brain functional connectivity in headache disorders: A narrative review of MRI investigations. Journal of Cerebral Blood Flow & Metabolism. 2019; 39(4): 650-69. [DOI:10.1177/0271678X17740794]
5. Lai Y-T, Wang T-C, Chuang L-J, Chen M-H, Wang P-C. Epidemiology of vertigo: A national survey. Otolaryngology--Head and Neck Surgery. 2011; 145(1): 110-6. [DOI:10.1177/0194599811400007]
6. Lempert Th, Neuhauser H. Epidemiology of vertigo, migraine and vestibular migraine. Journal of Neurology. 2009; 256(3): 333-8. [DOI:10.1007/s00415-009-0149-2]
7. Bahrami P, Zebardast H, Zibaei M, Mohammadzadeh M, Zabandan N. Prevalence and characteristics of headache in Khoramabad, Iran. Pain Physician. 2012; 15(4): 327-32. [DOI:10.36076/ppj.2012/15/327]
8. Ostovar R, Rashidian A, Pourreza A, Hossein Rashidi B, Hantooshzadeh S, Eftekhar Ardebili H, et al. Developing criteria for cesarean section using the RAND appropriateness method. BMC Pregnancy and Childbirth. 2010; 10(1): 52. [DOI:10.1186/1471-2393-10-52]
9. Manzoni GC, Stovner LJ. Epidemiology of headache. Handbook of Clinical Neurology. 2010; 97: 3-22. [DOI:10.1016/S0072-9752(10)97001-2]
10. Mitchell JM. Utilization trends for advanced imaging procedures: Evidence from individuals with private insurance coverage in California. Medical Care. 2008; 46(5): 460-6. [DOI:10.1097/MLR.0b013e31815dc5ae]
11. Lee SI, Saokar A, Dreyer KJ, Weilburg JB, Thrall JH, Hahn PF. Does radiologist recommendation for follow-up with the same imaging modality contribute substantially to high-cost imaging volume?. Radiology. 2007; 242(3): 857-64. [DOI:10.1148/radiol.2423051754]
12. Bridges JFP, Jones Ch. Patient-based health technology assessment: A vision of the future. International Journal of Technology Assessment in Health Care. 2007; 23(1): 30-5. [DOI:10.1017/S0266462307051549]
13. Sodickson A, Baeyens PF, Andriole KP, Prevedello LM, Nawfel RD, Hanson R, et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology. 2009; 251(1): 175-84. [DOI:10.1148/radiol.2511081296]
14. Ebrahimipour H, Mirfeizi SZ, Vafaee Najar A, Kachooei AR, Ariamanesh AS, Ganji R, et al. Developing an appropriateness criteria for knee MRI using the Rand appropriateness method (RAM)-2013. Archives of Bone and Joint Surgery. 2014; 2(1): 47-51.
15. Salari H, Ravanbod MR, Akbari Sari A, Farzanegan Gh, Esfandiari A. Developing appropriate indications for prescriptions of brain MRI using RAND appropriateness method. Evidence Based Health Policy, Management and Economics. 2017; 1(4): 205-10.
16. Lehnert BE, Bree RL. Analysis of appropriateness of outpatient CT and MRI referred from primary care clinics at an academic medical center: How critical is the need for improved decision support?. J Am Coll Radiol. 2010; 7(3): 192-7. [DOI:10.1016/j.jacr.2009.11.010]
17. Solivetti FM, Guerrisi A, Salducca N, Desiderio F, Graceffa D, Capodieci G, et al. Appropriateness of knee MRI prescriptions: Clinical, economic and technical issues. La Radiologia Medica. 2016; 121(4): 315-22. [DOI:10.1007/s11547-015-0606-1]
18. Ebrahimipour H, Mirfeizi SZ, Vejdani M, Vafaee-najar A, Kachooei AR, Ariamanesh AS, et al. Evaluation of medical costs resulting from inappropriate prescriptions of magnetic resonance imaging for knee joint, using RAND method in Ghaem hospital-2013. Hakim Research Journal. 2015; 17(4): 278-86. [In Persian]
19. Kavosi Z, Sadeghi A, Lotfi F, Salari H, Bayati M. The inappropriateness of brain MRI prescriptions: A study from Iran. Cost Effectiveness and Resource Allocation. 2021; 19(1): 1-6. [DOI:10.1186/s12962-021-00268-6]
20. Jahanmehr N, Bigdeli AS, Salari H, Mokarami H, KhodaKarim S, Damiri S. Analyzing inappropriate Magnetic Resonance Imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain. The International Journal of Health Planning and Management. 2019; 34(4): e1437-e47. [DOI:10.1002/hpm.2806]
21. Salari H, Ostovar R, Esfandiari A., Keshtkaran A, Sari AA, Yousefi Manesh H, et al. Evidence for policy making: Clinical appropriateness study of lumbar spine MRI prescriptions using RAND appropriateness method. International Journal of Health Policy and Management. 2013; 1(1): 17-21. [DOI:10.15171/ijhpm.2013.04]
22. Sadeghi A, Keshavarz Kh, Ahmadzadeh MS, Yousefi A. Survey of appropriate use of magnetic resonance imaging services provided in Shahid Chamran hospital of Shiraz. Journal of Health Research in Community. 2015; 1(3): 33-40. [In Persian]
23. Oikarinen H, Karttunen A, Pääkkö E, Tervonen O. Survey of inappropriate use of magnetic resonance imaging. Insights into imaging. 2013; 4(5): 729-33. [DOI:10.1007/s13244-013-0276-2]
24. Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population—a prevalence study. Journal of Clinical Epidemiology. 1991; 44(11): 1147-57. [DOI:10.1016/0895-4356(91)90147-2]
25. Neuhauser HK, Von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, et al. Epidemiology of vestibular vertigo: A neurotologic survey of the general population. Neurology. 2005; 65(6): 898-904. [DOI:10.1212/01.wnl.0000175987.59991.3d]
26. Salari H, Mohammadnia A, Zand P, Nemati R, Salimipour H, Omranikhoo H, et al. The clinical necessity of lumbar spine mag-netic resonance imaging prescriptions for low back pain in Bushehr teaching hospitals in 2018. Iranian South Medical Journal. 2020; 23(5): 465-74. [In Persian]
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