MacEwan D W, Dyck D R, Greenberg I D, Levi C S, Lyons E A, McClarty B M, van der Putten W J
Department of Radiology, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Radiographics. 1994 Sep;14(5):1109-18. doi: 10.1148/radiographics.14.5.7991817.
As part of a 5-year imaging management plan being developed for the single insurance carrier in Manitoba, the radiologic utilization for the province was reviewed. For the fiscal year 1993 (April 1, 1992, through March 31, 1993), 1,056,694 imaging studies were performed in a total patient population of 1,133,117 in 81 hospitals and 39 offices in which 648 units of equipment were operated by 773.4 full-time personnel at a cost of $100,302,812 ($75,227,109 in U.S. dollars). The skin dose for the total population for the year was 40,112 Gy, compared with 35,513 Gy in 1979. Since 1979, there has been a 9% increase in the number of radiologic examinations (from 972,426 examinations), a greater need for more personnel to conduct ultrasound, mammography, computed tomography, and magnetic resonance imaging examinations, and striking costs escalation (from $25,082,500 to $100,302,812). Reduction of total funding for imaging services will be possible only if the medical service infrastructure and physician behavior are altered, since imaging is a support service. Hospital services must be integrated and the infrastructure reduced, and physicians must adhere to guidelines and practice protocols for requesting consultations.
作为正在为马尼托巴省唯一的保险公司制定的一项为期5年的影像管理计划的一部分，对该省的放射学利用情况进行了审查。在1993财政年度（1992年4月1日至1993年3月31日），81家医院和39间诊所共为1,133,117名患者进行了1,056,694项影像检查，这些诊所配备了648台设备，由773.4名全职人员操作，费用为100,302,812加元（75,227,109美元）。该年度全省的皮肤剂量为40,112戈瑞，而1979年为35,513戈瑞。自1979年以来，放射学检查数量增加了9%（从972,426次检查），对更多人员进行超声、乳房X线摄影、计算机断层扫描和磁共振成像检查的需求更大，成本急剧上升（从25,082,500加元升至100,302,812加元）。由于影像是一项支持性服务，只有改变医疗服务基础设施和医生行为，才有可能减少影像服务的总资金投入。医院服务必须整合，基础设施必须精简，医生必须遵守会诊申请的指导方针和操作规范。
