Utilization Analysis of Magnetic Resonance Imaging under the National Health Insurance Scheme

• Main Authors: Kun-Ju Tsai, 蔡坤儒
• Other Authors: Shiao-Chi Wu
• Format: Others
• Language: zh-TW
• Published: 2001
• Online Access: http://ndltd.ncl.edu.tw/handle/15307464251255639361

碩士 === 國立陽明大學 === 公共衛生研究所 === 89 === The utilization of medical technology is one of the main reasons of the rising medical expenditure. In Taiwan, the number of Magnetic Resonance Imagine (MRI) has increased rapidly, 10 to 72 from 1990 to 1999. It deserves to research whether high technology utilization and medical expenditure are related to individual’s or hospital’s specific characters or not. The analysis is based on the national wide inpatient information from Jan. to Dec. of 1997, supplied by Bureau of National Health Insurance. This paper focuses on the relationship of MRI utilization between factors of individuals and different hospitals (i.e. Total inpatients group, neurological medicine group, nerve center system disease group). A regression model has been applied to find out potentially abnormal MRI utilization by hospitals and to provide a reference for professional examinations by Bureau of National Health Insurance. The key findings of this paper are as follows: 1.The utilization rate of MRI used by patients during the same period are: once is 94%, more than twice is 5.2%. The highest utilization frequency of MRI is 6 times. 2.The utilization rate by total inpatients group is 1.26%: 17.47% for neurological medicine patients group and 2.49% for nerve center system disease patients group. 3.The common effective factors for the above three patient groups are age, the category of insurance coverage, public and private hospitals, pieces of MRI equipment, CT utilization and average length of stay. 4.The analysis of utilization rate by total hospitals is 2.2%; 21.58% for hospitals of neurological medicine and 3.34% for hospitals of nerve center system disease. 5.Analysis of effective factors of utilization rate by hospitals are sex, the category of insurance coverage, the category of city countryside and pieces of MRI equipment; hospital level and the category of city countryside for hospitals of neurological medicine; the category of city countryside and pieces of MRI equipment for hospitals of nerve center system disease. This paper analyzed the hospital MRI utilization by adopting risk adjustment to analyze patients’ various case-mix. In that way, we can get an objective MRI rate. This result can be a reference in authority’s verification or hospital management.