Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T04:30:33.050Z Has data issue: false hasContentIssue false
  • English
  • Français

Determinants of computed tomography and magnetic resonance imaging utilization in Taiwan

Published online by Cambridge University Press:  02 March 2005

Pei-Tseng Kung ,
Wen-Chen Tsai ,
Chih-Liang Yaung  and
Kai-Ping Liao
Pei-Tseng Kung
Affiliation:
Taichung Healthcare and Management University
Wen-Chen Tsai
Affiliation:
China Medical University
Chih-Liang Yaung
Affiliation:
Taichung Healthcare and Management University
Kai-Ping Liao
Affiliation:
China Medical University
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Magnetic resonance imaging (MRI) and computerized tomography (CT) scanners are high-tech equipment with the highest utilizations and expenditures in Taiwan. This study investigates the factors that affect MRI and CT utilization, such as whether supply-side factors have more impact than demand-side factors, and the effect of utilization control policies.

Methods: This study used the nationwide CT and MRI claim data for the years 1998 to 2001 from the Bureau of National Health Insurance (BNHI) in Taiwan. Multiple regression analysis was the statistical method used to determine the relative factors that influence CT and MRI utilization.

Results: CT : population ratio, hospital-based physician : population ratio, female ratio, pediatric (≤14 years) : population ratio, and family income significantly influenced CT utilization. MRI : population ratio and hospital-based physician : population ratio, female ratio, and family income significantly influenced MRI utilization. However, the proportion of the aged (≥65 years of age) did not significantly influence CT or MRI utilization after controlling for other factors. The rates of CT and MRI utilization for the outpatient and inpatient settings and the repeated uses of CT or MRI have decreased significantly after a utilization review was implemented by BNHI, which suggests that CT and MRI have been overused.

Conclusions: Increases in supply-side factors significantly increase CT/MRI utilization, and supply-side factors impact CT/MRI utilization more than demand-side factors. The results show that the utilization instant report policy effectively decreases repeated uses of CT/MRI.

Keywords

Computerized tomographyMagnetic resonance imagingHigh-tech medical utilizationCTMRI
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 1 , January 2005 , pp. 81 - 88
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Becker GS. 1965; Theory of the allocation of time. Econo J. 75: 403– 517.Google Scholar
Boutwell RC, Mitchell JB. 1993; Diffusion of new technologies in the treatment of medicare population. Implications for patient access and program expenditures. Int J Technol Assess Health Care. 9: 62– 75.Google Scholar
Brown MM, Brown GC, Sharma S, Hollands H, Smith AF. 2001; Physician manpower and health care expenditures in the United States: A thirty-year perspective. J Health Care Finance. 27: 55– 64.Google Scholar
Bunge RE, Herman CL. 1987; Usage of diagnostic imaging procedures: A nationwide hospital study. Radiology. 163: 569– 573.Google Scholar
Bureau of National Health Insurance. Press Release, 16 May 2002. Available at: www.nhi.gov.tw/07information/news/data/89/news0706.htm.
Chiang TL. 2002; Analysis on trends for healthcare expenditures in Taiwan [In Chinese: English Abstract]. Taiwan J Public Health. 21: 157– 163.Google Scholar
Chu CL, Hsueh YS, Chiang TL. 2000; Does supply of physicians affect the use of ambulatory services by the insured?—Findings from the 1994 Taiwan Health Interview Survey [In Chinese: English Abstract]. Taiwan J Public Health. 19: 381– 388.Google Scholar
Garrison LP, Wilensky GR. 1986; Cost Containment and Incentives for Technology. Health Aff (Millwood). 5: 46– 58.Google Scholar
Getzen TE. 2000; Health care is an individual necessity and a national luxury: Applying multilevel decision model to the analysis of health care expenditures. J Health Econ. 19: 259– 270.Google Scholar
Gibson DJ, Eugene W. 1994; Caldwell lecture. Technology: The key to controlling health care costs in the future. AJR Am J Roentgenol. 163: 1289– 1293.Google Scholar
Grossman M. 1972; On the concept of health capital and the demand for health. J Polit Econ. 80: 223– 255.Google Scholar
Hellinger FJ. 1982; Controlling costs by adjusting payment for medical technologies. Inquiry. 19: 34– 43.Google Scholar
Hisashige A. 1994; MR imaging in Japan and the United States: Analysis of utilization and economics. AJR Am J Roentgenol. 162: 507– 510.Google Scholar
Hisashige A. 1994; The introduction and evaluation of MRI in Japan. Int J Technol Assess Health Care. 10: 392– 405.Google Scholar
Kennedy RH, Baker HL, Houser OW, et al. 1979; Neurological computer tomography in a defined population group. Radiology. 130: 153– 158.Google Scholar
Manning WG, Newhouse JP, Duan N, et al. 1987; Health insurance and the demand for medical care: Evidence from a randomized experiment. Am Econ Rev. 77: 251– 277.Google Scholar
Lazaro P, Fitch K. 1995; The distribution of “big ticket” medical technology in OECD countries. Int J Technol Assess Health Care. 11: 552– 570.Google Scholar
Lipper MH, Hillman BJ, Pates RD, et al. 1995; Ownership and utilization of MR imagers in the commonwealth of Virginia. Radiology. 195: 217– 221.Google Scholar
Mendelson DN, Schwartz WB. 1993; The effects of aging and population growth on health care costs. Health Aff (Millwood). 12: 119– 125.Google Scholar
Newhouse JP. 1992; Medical care costs: How much welfare loss? J Econ Perspect. 6: 3– 21.Google Scholar
Niki R. 1997; Why Japan has been a “winner” in a cost containment race?—Recent health care financing policy in Japan. APHA Conference. 107– 156.
Okunade AA, Murthy VNR. 2002; Technology as a ‘major driver’ of health care costs: A cointegration analysis of The Newhouse Conjecture. J Health Econ. 21: 147– 159.Google Scholar
Passariello R. 1997; Cost containment and diffusion of MRI: Oil and water? The situation in Europe. Eur Radiol. 7: 259– 262.Google Scholar
Peddecord KM, Janon EA, Robins JM. 1987; Use of MR imaging in an outpatient MRI center. AJR Am J Roentgenol. 148: 809– 812.Google Scholar
Roemer MI. 1961; Bed supply and hospital utilization: A national experiment. Hospital. 35: 36– 42.Google Scholar
Taiwan, Department of Health. 2002. Health and vital statistics. Taipei, Taiwan: Department of Health;
Tsai WC, Kung PT. 2001; Relationship between Chinese medical utilization and growth of physicians [In Chinese: English Abstract]. Taiwan J Public Health. 20: 463– 474.Google Scholar
Tsai WD, Li IH. 2002; Hospital nonprice competition and market structure: An empirical study of hospitals' acquisition of high-tech medical equipment. Acad Econ Papers. 30: 57– 78.Google Scholar
Van Tielen R, Peys F, Geneaer J. 1998; The demographic impact on ambulatory pharmaceutical expenditure in Belgium. Health Policy. 45: 1– 14.Google Scholar