Luxenburg Osnat, Vaknin Sharona, Pollack Gabriel, Siebzehner Miriam, Shemer Joshua
ICTAHC-Israeli Center for Technology Assessment in Health Care, Gertner Institute, Tel Hashomer, Israel.
Harefuah. 2003 Dec;142(12):810-4, 880.
One of the major factors contributing to the escalating increase in the costs of the health system is the accelerated utilization of health technologies such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Prior to this study in Israel, there was no available national database to ascertain the scope and utilization patterns of imaging technologies. A number of trends combine in the need to assess the utilization patterns in Israel. Firstly, imaging examinations constitute a larger and ever-growing predominate role in the diagnostic process. Secondly, these technologies can complement or supplement each other. Thirdly, the rising costs to the health system resulting from the numerous examinations conducted and finally, the importance of protecting public health from the damage caused by exposure to radiation during CT examinations.
The initial stage was to identify all the institutions operating CT or MRI devices. Data was collected by means of a questionnaire from these organizations on the extent of use, characteristics of the utilization patterns, indications, accessibility, availability, and referents etc. during the period 1995-1999.
In the year 2000, 38 CT and 9 MRI devices were operating in Israel. We observed an increase in the number of CT and MRI examinations between the years 1995-1999 and a rise in the level of examinations per 1,000 population. The rate of MRI examinations per person in Israel was found to be lower in comparison to other Western countries. Upon analysis of the distribution of indications it was found that approximately 37% of the CT examinations were cranial examinations and 18% were spinal examinations. In MRI examinations 38% were cranial and 30% spinal tests.
The rising trends in the rate of CT and MRI examinations during the period 1995-1999 and their characteristics, match the comparable rise witnessed in most Western countries in recent years. Although the level of CT and MRI devices per population in Israel is low in comparison to the Western world, the devices operate intensively. In light of the high level of accessibility and availability of these imaging devices in Israel, the research findings corroborate the claim that the number of devices influences the scope of utilization and supports the supposition that these imaging devices are used efficiently in Israel.
导致卫生系统成本不断攀升的主要因素之一是计算机断层扫描(CT)和磁共振成像(MRI)等医疗技术的加速应用。在以色列开展本研究之前,尚无可用的国家数据库来确定成像技术的应用范围和使用模式。在以色列,有多种趋势促使人们需要评估成像技术的使用模式。首先,成像检查在诊断过程中占据着越来越大且不断增长的主导地位。其次,这些技术可以相互补充。第三,大量检查给卫生系统带来的成本不断上升,最后,保护公众健康免受CT检查过程中辐射伤害的重要性。
初始阶段是确定所有运营CT或MRI设备的机构。通过问卷调查从这些组织收集了1995 - 1999年期间的使用程度、使用模式特征、适应症、可及性、可用性和转诊情况等数据。
2000年,以色列有38台CT设备和9台MRI设备在运行。我们观察到1995 - 1999年期间CT和MRI检查的数量有所增加,且每千人口的检查水平有所上升。与其他西方国家相比,以色列人均MRI检查率较低。经分析适应症分布发现,约37%的CT检查为头部检查,18%为脊柱检查。在MRI检查中,38%为头部检查,30%为脊柱检查。
1995 - 1999年期间CT和MRI检查率的上升趋势及其特征,与近年来大多数西方国家所见证的类似上升情况相符。尽管以色列人均CT和MRI设备水平与西方世界相比很低,但这些设备使用频繁。鉴于这些成像设备在以色列的高可及性和可用性,研究结果证实了设备数量会影响使用范围这一说法,并支持了这些成像设备在以色列得到有效使用的假设。