Study on medical diagnostic radiation utilization and collective dose estimationin Taiwan

• Main Authors: Ren-Hsiang Lin, 林仁祥
• Other Authors: Wan-hua Hsieh
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/72114523141245477859

碩士 === 慈濟大學 === 公共衛生研究所 === 96 === PURPOSEThe national health insurance has been implemented in the whole country of Taiwan since 1995 and the cover rate has achieved above 98%. With this policy, people can receive medical care which is more accessible and cheaper than that in other countries. The objective of this dissertation is to explore theutilization and collective dose estimation of clinic radiation diagnostic throughout these years.MATERIALS AMD METHODSWe analyzed the data files from the National Health Insurance Application databank which consisted of random sampling data collected by the National Health Research Institute from 1997 to 2004. The parameters for analysis included gender, age, clinic radiological examination item, and diagnosis andhospital code. The collective dose estimation used the biggest dose range of each clinic radiological examination from preciously published paper.RESULTAccording to the data, there were 863.7 examinations per 1000 inhabitants estimated in 2004, and the yearly increase rate was 7.16% since 1997. The CT and mammography were estimated to be 42.2 and 7.9 examinations per 1000 inhabitants, which represented 8.61% and 13.12% yearly increases,respectively. General routine X ray and CT contributed 91.4% and 5%examinations, respectively. The ratio of CT and MRI to general routine examination is 0.05 and 0.02, and increased 1.14% and 10.09% yearly, respectively. We estimated the collective dose to be 11028 person-Sv (0.51 mSv per inhabitant) in 1997, and then 24880 person-Sv (0.75 mSv per inhabitant) in 2004. The frequency of CT represented about 5% of all examinations, and contributed 31 to 36% of total collective doses. The frequencies of CT and general routine X-ray increased by year in hospitalized category, in which male increased higher than female, regional hospital raised higher than local hospital and medical center. The highest increased frequency were shown at the people who were hospitalized, more than 70 years old, male, and in regionalhospitals.Conclusion:The increment on examination frequency since 1997 resulted in collective dose raising and enhanced the risk of cancer. The highest increased frequency margins of general radialogic examination and CT were shown at the people who were hospitalized, more than 70 years old, male, and in regional hospitals.The frequency of CT represented about 5% of all examinations, and contributed 31 to 36% of total collective doses. The higher frequenies of Mammography were shown between 30 to 60 years old; in future, health policy makers should develop strategies to improve mammography examination for theaging group to decrease the breast cancer death rate.