Shin Jaeyong, Choi Yoon Jung, Choi Young, Lee Sang Gyu, Kim Ji Man
Department of Preventive Medicine, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Gyeonggi-do 16499, Korea.
Health Insurance Review and Assessment Service, 60 Hyeoksin-ro, Wonju, Gangwon-do 26465, Korea.
Healthcare (Basel). 2019 Dec 19;8(1):2. doi: 10.3390/healthcare8010002.
Because the high-cost of medical imaging can cause a tremendous economic burden across the health care system, we investigated factors associated with taking additional computed tomography (CT) scans. Data of gastric cancer patients were eligible for analysis if the patient underwent a gastrectomy during the study period (2002-2013). We defined initial CT scans as those taken within 90 days from the surgery date. If there was an additional CT scan between the date of an initial CT scan and the surgery date, we regarded it as a reexamination. We used multivariate logistic regression analysis for reexamination CT scans. Among 3342 gastrectomy patients, 1165 participants underwent second CT scans. Transfer experience (adjusted odds ratio (OR) = 23.87, 95% confidence interval (CI) = 18.15-31.39) was associated with higher OR for reexamination. Among transferred patients, an increased number per 100 beds at the initial CT hospital was associated with a decreased OR for reexamination (OR = 0.88, 95% CI = 0.83-0.94), but increased beds in surgery hospitals was related to an increased OR for reexamination (OR = 1.29, 95% CI = 1.20-1.36). In our study, transfer experience, initial CT scan in a low-volume hospital, and surgical treatment in a high-volume hospital were associated with reexamination CT scans.
由于医学成像的高成本会给整个医疗保健系统带来巨大的经济负担，我们调查了与进行额外计算机断层扫描（CT）相关的因素。如果胃癌患者在研究期间（2002 - 2013年）接受了胃切除术，其数据则符合分析条件。我们将初次CT扫描定义为手术日期起90天内进行的扫描。如果在初次CT扫描日期和手术日期之间进行了额外的CT扫描，我们将其视为复查。我们对复查CT扫描进行了多因素逻辑回归分析。在3342例胃切除术患者中，1165名参与者接受了第二次CT扫描。转院经历（调整后的优势比（OR）= 23.87，95%置信区间（CI）= 18.15 - 31.39）与更高的复查OR相关。在转院患者中，初次CT扫描医院每增加100张床位与复查OR降低相关（OR = 0.88，95% CI = 0.83 - 0.94），但手术医院床位增加与复查OR升高相关（OR = 1.29，95% CI = 1.20 - 1.36）。在我们的研究中，转院经历、在低容量医院进行初次CT扫描以及在高容量医院进行手术治疗与复查CT扫描相关。
