住院患者 CT 和 MRI 利用情况：在学术医院环境中的趋势。

Inpatient CT and MRI utilization: trends in the academic hospital setting.

机构信息

Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA, USA.

出版信息

J Am Coll Radiol. 2010 Dec;7(12):949-55. doi: 10.1016/j.jacr.2010.08.015.

DOI:10.1016/j.jacr.2010.08.015

PMID:21129686

Abstract

PURPOSE

The aim of this study was to determine trends in the utilization of inpatient CT and MRI at academic medical centers.

METHODS

Surveys requesting inpatient CT volumes, inpatient MRI volumes, discharges excluding newborns, and case-adjusted mix index from 2002 to 2007 were e-mailed to all 123 members of the Society of Chairmen of Academic Radiology Departments. CT and MRI studies per discharge were adjusted using the case mix index (CMI) provided by each hospital to adjust for the differences in patient mix at participating institutions. Trends in adjusted inpatient imaging utilization were compared over time and across responding institutions.

RESULTS

Twenty-two of 123 chairs (17.9%) of academic radiology departments, representing all geographic regions and a wide variability in National Institutes of Health research funding ranking, provided responses to our survey. Between 2002 and 2007, there was an increase in median CMI-adjusted CT studies per discharge of 28.0% and an increase in median CMI-adjusted MRI studies per discharge of 19.8%. The largest annual percentage increase in CT utilization (20.2%) occurred from 2003 to 2004, and there was negative growth between 2006 and 2007 of -3.74%. The largest annual percentage increase in MRI utilization (13.9%) occurred from 2006 to 2007, with 3 years of negative growth from 2002 to 2003, 2004 to 2005, and 2005 to 2006. In 2007, there was a wide range in CMI-adjusted CT studies per discharge between institutions from 0.16 to 0.75, with a mean of 0.40 ± 0.18, with a corresponding wide range in CMI-adjusted MRI studies per discharge of 0.04 to 0.16, with a mean of 0.09 ± 0.03.

CONCLUSION

There has been large growth in inpatient CT and MRI utilization at academic medical centers. This growth is variable over time and between institutions. Practice leaders can use this information to compare themselves with their peers and to monitor the impact of programmatic improvements on inpatient imaging utilization and in discussions with health system leaders who would like to improve system profitability by decreasing costly inpatient imaging procedures.

摘要

目的

本研究旨在确定学术医疗中心住院 CT 和 MRI 利用趋势。

方法

通过电子邮件向 123 位学术放射学主席协会的所有成员发送了 2002 年至 2007 年期间的住院 CT 量、住院 MRI 量、不包括新生儿的出院人数和病例调整混合指数的调查。使用每家医院提供的病例组合指数（CMI）对 CT 和 MRI 研究进行调整，以调整参与机构中患者组合的差异。比较了不同时间和不同机构的调整后住院影像利用率的趋势。

结果

123 位学术放射学主席中有 22 位（17.9%）代表了所有地理区域和 NIH 研究经费排名的广泛差异，对我们的调查做出了回应。2002 年至 2007 年间，出院患者每例 CT 研究的中位数 CMI 调整后增加了 28.0%，每例 MRI 研究的中位数 CMI 调整后增加了 19.8%。CT 利用率的最大年增长率（20.2%）发生在 2003 年至 2004 年，而 2006 年至 2007 年则出现负增长，为-3.74%。MRI 利用率的最大年增长率（13.9%）发生在 2006 年至 2007 年，而 2002 年至 2003 年、2004 年至 2005 年和 2005 年至 2006 年期间出现了 3 年的负增长。2007 年，各机构之间的出院患者每例 CT 研究的 CMI 调整后差异较大，从 0.16 到 0.75，平均值为 0.40±0.18，相应的出院患者每例 MRI 研究的 CMI 调整后差异较大，从 0.04 到 0.16，平均值为 0.09±0.03。