Baiguissova Dinara, Laghi Andrea, Rakhimbekova Assel, Fakhradiyev Ildar, Mukhamejanova Aigerim, Battalova Galina, Tanabayeva Shynar, Zharmenov Samat, Saliev Timur, Kausova Galina
S.D. Asfendiyarov Kazakh National Medical University Almaty Kazakhstan.
National Scientific Center of Surgery A.N.Syzganov Almaty Kazakhstan.
Health Sci Rep. 2023 Mar 13;6(3):e1102. doi: 10.1002/hsr2.1102. eCollection 2023 Mar.
Up to date, no research on the economic efficacy of diagnostic modalities, such as magnetic resonance imaging (MRI) and computerized tomography (CT), has been done in Central Asia. The aim of this study was to analyse the inappropriate appointments of MRI and CT scanning procedures in Kazakhstan.
We used the imaging diagnostic reports and medical records from 9725 planned outpatient CT and MRI exams performed in two major hospitals in Almaty. The study period was for the period 2014-2019. The independent experts-radiologists evaluated the MRI and CT exams for validity using the ACR® compliance standards and RCR recommendations.
The results showed that the combined costs of MRI and CT scans increased by $17.982 between 2014 ($22.537) and 2019 ($40.519), = 0.002. The highest rate of MRI examinations was observed in 2019, with a rate of 6.9 per 10,000 people. It was determined that in 2019 the highest rate for men who undertook CT was equal to 12.4 per 10,000 people, while for women it was equivalent to 5.7 per 10,000 patients. The majority of non-corresponding imaging examinations ( = 1304) were referred for MRI and CT scans by general practitioners. We detected the irrational referrals for head and neck radiological examinations in = 178 (13.7%) cases, and the abdominal cavity checks in = 249 (19.1%) cases ( = 0.001). The main portion of erroneously unreasonable referrals for examination of the abdominal organs was made by surgeons in = 43 (3.3%) cases.
The findings indicated an increase in the number of referrals for unnecessary CT and MRI tests over the research period (2014-2019). It had a substantial impact on the rise in healthcare system expenses. The results demonstrate the need for the education of GPs and improving the approaches for diagnostics.
截至目前，中亚地区尚未开展关于磁共振成像（MRI）和计算机断层扫描（CT）等诊断方式的经济疗效研究。本研究旨在分析哈萨克斯坦MRI和CT扫描程序的不当预约情况。
我们使用了阿拉木图两家主要医院9725例计划门诊CT和MRI检查的影像诊断报告和病历。研究时间段为2014年至2019年。独立专家放射科医生根据美国放射学会（ACR®）合规标准和英国皇家放射学院（RCR）建议评估MRI和CT检查的有效性。
结果显示，MRI和CT扫描的总费用在2014年（22537美元）至2019年（40519美元）期间增加了17982美元，P = 0.002。2019年MRI检查率最高，为每万人6.9例。经确定，2019年进行CT检查的男性最高比率为每万人12.4例，女性为每万人5.7例。大多数不相符的影像检查（n = 1304）是由全科医生转诊进行MRI和CT扫描的。我们在178例（13.7%）病例中检测到头颈部放射学检查的不合理转诊，在249例（19.1%）病例中检测到腹腔检查的不合理转诊（P = 0.001）。腹部器官检查中错误的不合理转诊主要由外科医生进行，共43例（3.3%）。
研究结果表明，在研究期间（2014 - 2019年），不必要CT和MRI检查的转诊数量有所增加。这对医疗系统费用的上涨产生了重大影响。结果表明需要对全科医生进行教育并改进诊断方法。
