Diffusion, utilisation and regional variations in the use of CT and MRI in Sweden

Olsson, Silas

doi:10.1016/s0169-2607(01)00155-9

Cited by 19 publications

(12 citation statements)

References 4 publications

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“…Hence, it is difficult to assess the level of overall variation found in our study compared to other studies. However, our study is very much in line with results from studies of geographical variations with regard to particular modalities, such as CT and MRI [13]. …”

Section: Discussionsupporting

confidence: 90%

Geographical variation in radiological services: a nationwide survey

Lysdahl

Børretzen

2007

BMC Health Serv Res

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Background: Geographical variation in health care services challenges the basic principle of fair allocation of health care resources. This study aimed to investigate geographical variation in the use of X-ray, CT, MRI and Ultrasound examinations in Norway, the contribution from public and private institutions, and the impact of accessibility and socioeconomic factors on variation in examination rates.

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Section: Discussionsupporting

confidence: 90%

Geographical variation in radiological services: a nationwide survey

Lysdahl

Børretzen

2007

BMC Health Serv Res

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“…Other countries and health systems with universal coverage face similar challenges-differences in health care use by SES are reported, with reports on pro-rich inequity in specialty care use [5-8] and in performance of diagnostic imaging tests [15,34]. Studies on primary care use by SES are mixed, with some showing an equitable (i.e., needs-based) distribution across SES groups [6,10], while others support the findings reported here, showing that person of poorer economic status use more primary care services than their richer counterparts [35].…”

Section: Discussionmentioning

confidence: 99%

Assessing socioeconomic health care utilization inequity in Israel: impact of alternative approaches to morbidity adjustment

et al. 2011

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BackgroundThe ability to accurately detect differential resource use between persons of different socioeconomic status relies on the accuracy of health-needs adjustment measures. This study tests different approaches to morbidity adjustment in explanation of health care utilization inequity.MethodsA representative sample was selected of 10 percent (~270,000) adult enrolees of Clalit Health Services, Israel's largest health care organization. The Johns-Hopkins University Adjusted Clinical Groups® were used to assess each person's overall morbidity burden based on one year's (2009) diagnostic information. The odds of above average health care resource use (primary care visits, specialty visits, diagnostic tests, or hospitalizations) were tested using multivariate logistic regression models, separately adjusting for levels of health-need using data on age and gender, comorbidity (using the Charlson Comorbidity Index), or morbidity burden (using the Adjusted Clinical Groups). Model fit was assessed using tests of the Area Under the Receiver Operating Characteristics Curve and the Akaike Information Criteria.ResultsLow socioeconomic status was associated with higher morbidity burden (1.5-fold difference). Adjusting for health needs using age and gender or the Charlson index, persons of low socioeconomic status had greater odds of above average resource use for all types of services examined (primary care and specialist visits, diagnostic tests, or hospitalizations). In contrast, after adjustment for overall morbidity burden (using Adjusted Clinical Groups), low socioeconomic status was no longer associated with greater odds of specialty care or diagnostic tests (OR: 0.95, CI: 0.94-0.99; and OR: 0.91, CI: 0.86-0.96, for specialty visits and diagnostic respectively). Tests of model fit showed that adjustment using the comprehensive morbidity burden measure provided a better fit than age and gender or the Charlson Index.ConclusionsIdentification of socioeconomic differences in health care utilization is an important step in disparity reduction efforts. Adjustment for health-needs using a comprehensive morbidity burden diagnoses-based measure, this study showed relative underutilization in use of specialist and diagnostic services, and thus allowed for identification of inequity in health resources use, which could not be detected with less comprehensive forms of health-needs adjustments.

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“…It is well established that there is widespread regional variation in the use of radiodiagnostics in the UK, Sweden and Norway. This is combined with concern that there is underutilization of high‐value capital equipment such as CT scanners in England.…”

Section: Discussionmentioning

confidence: 99%