Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants

Abstract

SummaryBackgroundLow‐income and middle‐income countries have a lot of problems in providing the financial, human, and capital resources for advanced medical imaging technologies (AMITs). Proper distribution of such expensive equipment might increase access to these services and enhance the quality and efficiency of health care. The present study aimed to identify the factors affecting the diffusion of AMITs including CT and MRI in Iran.MethodsThis is a qualitative research conducted in 2017. A number of purposively chosen policy makers and managers from Ministry of Health, medical universities, hospitals, health insurance, and vendor companies were approached for face‐to‐face and semistructured interviews. Data analysis was done using thematic analysis method.ResultsThree categories of influential factors were identified, including contextual, stakeholder related, and situational factors. With regards to the stakeholders, the ministry and physicians played the most important role in the diffusion process of the AMITs. Health insurance organizations and vendor companies played a minor role in distribution of the equipment. Application of political pressure by the authorities on the Ministry of Health to issue licenses for the acquisition of AMITs was taken as the most important factor and the greatest challenge in the diffusion of devices.ConclusionThe results sought to assist health system authorities to manage diffusion of AMITs effectively and assign an equitable access to the expensive resources. The diffusion management together with utilization management could largely improve efficiency and cost containment. Medical technology diffusion management de facto needs policy instruments in both supply and demand sides.

Explaining the adoption and use of computed tomography and magnetic resonance image technologies in public hospitals

“…In line with this, Harstall [ 29 ] reported that hospital size, teaching role, greater specialization, research activity and resource availability were positively associated with technology adoption. In turn, Abedini et al [ 30 ] concluded that the main factors influencing CT and MRI adoption were the number of beds, doctors and patients and hospital location, whereas Hong [ 31 ] showed that the number of CT units reflected bed and specialty numbers and, most especially, location in larger cities. Finally, Hall [ 32 ] found that greater use of diagnostic technologies was associated with greater population density, more doctors per capita, a higher ratio of specialists to general practitioners and a higher percentage of doctors involved in teaching.…”

Utility of Circulating Tumor Cells for Detection of Early-Stage Luminal A Breast Cancer

“…More importantly, the CTC group spent approximately 50% less time undergoing imaging than the control group ( Figure 3B). While traditional imaging (DUS, CT and MRI) remains indispensable for followup of cancer patients, 32 specialists and expensive equipment are needed to perform CT and MRI. 33 Therefore, the price of imaging examination only decreased by approximately 15%, and there is limited opportunity for further price decreases.…”

The Main Molecular and Serological Methods for Diagnosing COVID-19: An Overview Based on the Literature

“…The Canadian guidelines are mostly concordant with the WHO recommendations for primary screening of suspected cases by RT-qPCR [ 127 ], as well as India [ 8 ], Brazil [ 128 ], Portugal [ 129 ], and China [ 130 ]. However, in Iran, a shortage of RT-qPCR testing kits led local medical authorities to establish an imaging-driven screening system, with chest CT representing the first-line diagnostic modality [ 131 ], even though there were only 6.5 CT scanners per million population [ 132 ]. The shortage of RT-qPCR kits has not only been reported in middle-income countries but also in certain states of the United States at times when there were peaks in the number of COVID-19 cases [ 133 ].…”