文章基本信息

标题：The inappropriateness of brain MRI prescriptions: a study from Iran
本地全文：下载
作者：Zahra Kavosi ; Abouzar Sadeghi ; Farhad Lotfi 等
期刊名称：Cost Effectiveness and Resource Allocation
印刷版ISSN：1478-7547
电子版ISSN：1478-7547
出版年度：2021
卷号：19
期号：1
页码：1-6
DOI：10.1186/s12962-021-00268-6
出版社：BioMed Central
摘要：Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating the rate of inappropriate brain Magnetic Resonance Imaging (MRI) prescriptions and their financial burden in Iran. Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. About 21 percentage of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P < 0.01) had significant relationships with prescription appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99,988 US dollar in 2017. More than one-fifth of brains MRIs were inappropriate (i.e. prescriptions without medical indications). It caused 99,988 United States Dollar (USD) financial burden which is 17 times that of Iran's Gross Domestic Product (GDP) per capita. To better allocate resources for the provision of MRI services to health system, rationing policies for controlling moral hazard and reducing provider induced demand can be helpful.
其他摘要：Abstract Background Inappropriate prescriptions can lead to adverse consequences for patients. It also imposes excessive cost on the patients, payers and health systems. The current study aimed at estimating the rate of inappropriate brain Magnetic Resonance Imaging (MRI) prescriptions and their financial burden in Iran. Methods Using systematic stratified sampling method, this cross-sectional study recruited 385 participants from three public teaching hospitals in Shiraz, Iran. Demographic information, questions related to brain MRI prescription and its indications checklist were collected using study-specific data collection tools. The completed indications checklist was compared to the appropriateness status table of indications and scenarios to detect the percent of the appropriateness of prescriptions. Results About 21 percentage of total brain MRI prescriptions are inappropriate. Previous treatment, number of referrals to physician, having other diagnostic tests and the applicant of MRI (P < 0.01) had significant relationships with prescription appropriateness. The estimated financial burden of inappropriate brain MRIs in Shiraz teaching hospitals was 99,988 US dollar in 2017. Conclusions More than one-fifth of brains MRIs were inappropriate (i.e. prescriptions without medical indications). It caused 99,988 United States Dollar (USD) financial burden which is 17 times that of Iran's Gross Domestic Product (GDP) per capita. To better allocate resources for the provision of MRI services to health system, rationing policies for controlling moral hazard and reducing provider induced demand can be helpful.
关键词：Magnetic Resonance Imaging ; Health Expenditures ; Medical Overuse ; Unnecessary Procedures ; Neurology ; Prescriptions