Article

Health Insurers and Medical-Imaging Policy - A Work in Progress

New England Journal of Medicine (Impact Factor: 55.87). 04/2009; 360(10):1030-7. DOI: 10.1056/NEJMhpr0808703
Source: PubMed
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    • "Concern over the increased use of CT scans in pediatrics is especially apt, because children are more susceptible to the effects of radiation than are adults[3]. CT, MRI, and ultrasound are responsible for much of the increased use of imaging, but utilization rates for nuclear medicine and angiography/fluoroscopy are also on the rise[4,5]. Although the total cost of medical imaging to the health care system cannot be readily determined, an analysis of Medicare costs estimated that $14 billion was spent on diagnostic imaging in 2006, which was double the amount spent just 7 years earlier[6]. "
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    ABSTRACT: Misuse and overuse of medical imaging have gained widespread attention due to rising costs, radiation exposure risks, and limited comparative effectiveness evidence. Involving patients in shared decision making offers an opportunity to more clearly define risks and benefits, thus allowing patients to consider both personal values and the best available evidence.
    Preview · Article · Mar 2014 · North Carolina medical journal
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    • "Not surprisingly, the radiation exposure has increased in trauma patients over time. On the other hand, imaging has been the highest rate of growth among all healthcare services cost between 2000 and 2006, increasing at 17% per year.9 Thus, unnecessary exposure to ionizing radiation by overuse of head CT has raised concerns for patients, health care providers and regulators. "
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    ABSTRACT: Objective: Computed tomography (CT) scan has been an increasingly essential diagnostic tool for emergency physicians (EPs) to triage emergency patients. Canadian computed tomography Head Rule (CCHR) had been established and widely used to spare patients with mild head injury from unnecessary radiation. However, the awareness of CCHR and its actual utilization among Chinese EPs were unknown. This survey was to investigate the awareness and use of CCHR and their associated characteristics among Chinese EPs. Methods: Questionnaire was randomly sent to EPs from different Chinese hospitals. Surveyed EPs were asked how well they know about the CCHR and how often they use the CCHR to guide head CT use. Association between the awareness and utilization of CCHR and the physicians’ characteristics were analyzed using repeated-measures logistic regression. Results: About 41.7% of the total 247 responders noted they “very familiar” or “somewhat familiar” with CCHR while the utilization rate was 24.7%. With respect to the most important underlying barriers for the use of CCHR, approximate half (48.5%) cited “fear of malpractice” as the leading cause. “Received specific training regarding radiation dose of CT” was the significant predicting factor both for the awareness (OR 5.87; 95% CI, 3.08-11.21) and the use (OR 6.10, 95% CI, 2.91-12.80) of CCHR. Conclusions: Fear of malpractice and lack of radiation risk knowledge were two main barriers to apply CCHR in the request of CT for patients with mild head injury. Furthermore, EPs with specific training about radiation risk of CT were more likely to know and use of CCHR.
    Full-text · Article · Jul 2013 · Pakistan Journal of Medical Sciences Online
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    • "Medical imaging plays an important role in patients' care and is continuously being used in managing health and disease [2], [3]. For example, it is used in prevention, early detection of disease, choosing an optimal treatment, during surgical interventions, monitoring of treatment effects, etc. [3]. "
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    ABSTRACT: Medical imaging plays an important role in patients' care and is continuously being used in managing health and disease. To obtain the maximum benefit from this rapidly developing technology, further research is needed. Ideally, this research should be done in a patient-safe and environment-friendly manner; for example, on phantoms. The goal of this work was to develop a protocol and manufacture a multimodal liver phantom that is suitable for ultrasound, computed tomography, and magnetic resonance imaging modalities. The proposed phantom consists of three types of mimicked soft tissues: liver parenchyma, tumors, and portal veins, that are made of six ingredients: candle gel, sephadex®, agarose, glycerol, distilled water, and silicone string. The entire procedure is advantageous, since preparation of the phantom is simple, rather cost-effective, and reasonably quick - it takes around 2 days. Besides, most of the phantom's parts can be reused to manufacture a new phantom. Comparison of ultrasound images of real patient's liver and the developed phantom shows that the phantom's liver tissue and its structures are well simulated.
    Full-text · Article · May 2013 · PLoS ONE
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