Appropriateness of knee MRI prescriptions in a hospital of Birjand, 2014

Abstract

<p class="abstract"><strong>Background:</strong> Knee pain is one of the most common complains which cause patients to visit a doctor and Magnetic Resonance Imaging (MRI) is one of the common diagnostic methods which are common to find the cause of Knee pain. This study aim to determine knee MRI appropriateness, in Valiasr hospital of Birjand in 2014.</p><p class="abstract"><strong>Methods:</strong> In this study descriptive – analytical study, 150 patients referred to MRI unit were selected using convenient sampling method. Data were gatherers using a Questionnaire and then analyzed by SPSS16 using descriptive statistics and Pearson, chi-square and Fisher's exact tests. </p><p class="abstract"><strong>Results:</strong> Of 150 cases, 70 (46.7%) were considered inappropriate, 7 (4.7%) were uncertain, and 73 (48.7%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was 46200000 Rails. A statistical significant relation was observed between appropriateness of prescription with sex, jobs, education, physician specialist and referring institution.</p><strong>Conclusions:</strong> Considering the high rate of inappropriate prescriptions, it is necessary to find the causes. Developing, customization, and perform clinical guidelines in all of our country may help reducing this rate.

Analyzing inappropriate magnetic resonance imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain

“…The research results indicated that 56.7%, 39.7%, and 3.6% of the prescriptions were appropriate, inappropriate, and uncertain, respectively. Results from other studies confirmed the inappropriate lumbar and knee MRI prescriptions in Iran . Studies previously conducted in Iran show that the inappropriate lumbar MRI prescriptions varied from 2.6% to 80% and could be attributed to differences in the clinical guidelines used, the prevalence of musculoskeletal disorders, and level of access to MRI centers in different parts of Iran .…”

“…This intervention could reduce the ethical hazards and requests made by individuals having supplementary insurance because of the additional cost . It is possible for insurance organizations to reduce their economic burden and that of patients by providing training and departments that supervise physician prescriptions in accordance with clinical guidelines …”

“…Mohammadi et al reported that private and public MRI centers accounted for approximately 20% and 30% of the inappropriate prescriptions, respectively . Vejdani et al reported that ethical hazards associated with unnecessary use of MRI in private hospitals were approximately twice that for public hospitals and supplementary insurance was an important cause …”

“…10 Vejdani et al reported that ethical hazards associated with unnecessary use of MRI in private hospitals were approximately twice that for public hospitals and supplementary insurance was an important cause. 23 Inappropriate prescriptions and unnecessary use of high-tech imaging methods, especially MRI, is a problem in the Iranian health system and in other developing 26,27 and developed countries. 28,29 Emery et al at Alberta University Hospital reported that only 44.3% of the lumbar MRI prescriptions were appropriate.…”

“…20 It is possible for insurance organizations to reduce their economic burden and that of patients by providing training and departments that supervise physician prescriptions in accordance with clinical guidelines. 23 The results showed that individuals aged 46 to 60 years received most of the lumbar MRI prescriptions.…”