The Survey On The Usage Of CT And MRI At Two Hospitals In A City

[The Backdrop to the Survey and the Aim of the Survey] The X-ray Computed Tomography (CT) equipment and the Magnetic Resonance Imaging (MRI) machine are large medical equipment widely used in China. The usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI), can improve medical institution’s capacity to diagnose, prevent and treat diseases and improve human health, also has negative effects. How to use the X-ray Computed Tomography (CT) equipment and the Magnetic resonance imaging (MRI) machine in a proper, scientific and effective way is an issue urgently needed to be addressed when China’s health care reform is underway. This survey hopes to analyze the factors affecting the proper usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI) and put forward suggestions for the proper usage of large medical equipment such as the X-ray Computed Tomography (CT) equipment and the Magnetic resonance imaging (MRI) machine by surveying the usage of the X-ray Computed Tomography (CT) equipment and the Magnetic resonance imaging (MRI) machines in a city.[The Content and the Researching Methods in the Survey] Sampling and questionnaires were used in this survey. To learn the condition of the usage of the X-ray Computed Tomography(CT) equipment and the Magnetic resonance imaging(MRI) machines at the above-mentioned two hospitals and to analyze the factors affecting the proper usage of the X-ray Computed Tomography(CT) and the Magnetic resonance imaging(MRI), cases of pneumonia, lung cancer and malignant brain tumor at two hospitals(one is a 3 A grade hospital and the other one is a 2A grade hospital) were sampled and the usage of the X-ray Computed Tomography(CT) equipment and the Magnetic resonance imaging(MRI) machines at the above-mentioned two hospitals was evaluated by using tools that have been developed.[Major results of the Survey]1. The usage of the X-ray Computed Tomography (CT) is relatively proper. The X-ray Computed Tomography (CT) is more insufficiently used than excessively usedThe usage of the X-ray Computed Tomography (CT) was evaluated 301 times. In 80.4% of these evaluations, the X-ray Computed Tomography (CT) was found to be properly used. The X-ray Computed Tomography (CT) was found to be properly used in 215(which account for 95.6% of the total evaluations) of the 225 evaluations of the usage of the X-ray Computed Tomography (CT) for examination. The X-ray Computed Tomography (CT) was only improperly used (namely excessively used) 9 times, accounting for only 4% of the evaluations of the usage of the X-ray Computed Tomography (CT) for examination. In 0.4% of the evaluations of the usage of the X-ray Computed Tomography (CT) for examination, whether the X-ray Computed Tomography (CT) was properly used has not been determined; In 27 (which account for 35.5% of the evaluations) of 76 evaluations of the usage of the X-ray Computed Tomography (CT)(not for examination), the X-ray Computed Tomography(CT) was properly used. In 46 (which account for 60.5% of the evaluations) of 76 evaluations of the usage of the X-ray Computed Tomography (CT)(not for examination), the X-ray Computed Tomography(CT) was improperly used(namely insufficiently used. In 4% of 76 evaluations of the usage of the X-ray Computed Tomography (CT)(not for examination), whether the X-ray Computed Tomography(CT) was properly used has not been determined. Overall, the usage of the X-ray Computed Tomography (CT) is relatively proper. The X-ray Computed Tomography (CT) was more properly used for examination than it was used for other purposes. The X-ray Computed Tomography (CT) is more insufficiently used than excessively used.2. The factors affecting the proper usage of the X-ray Computed Tomography (CT)The results of the single factor analysis showed that the kind of the disease was the factor affecting the proper usage of the X-ray Computed Tomography (CT) when the X-ray Computed Tomography (CT) was used for examination and factors affecting the proper usage of the X-ray Computed Tomography (CT) when the X-ray Computed Tomography (CT) was not used for examination include:the level of the hospital, the kind of the disease, the complexity of the disease and the age of the patient. The results of the multi-factor analysis showed that, among all the cases sampled, the factors affecting the proper usage of the X-ray Computed Tomography (CT) include the kind of disease and hospitalization. In logistic regression analysis of the samples of the usage of the X-ray Computed Tomography (CT) for examination, it can be found that the kind of disease was the factor affecting the proper usage of the X-ray Computed Tomography (CT). The use of the X-ray Computed Tomography (CT) was the most improper when the X-ray Computed Tomography (CT) was used to examine the lung cancer. In logistic regression analysis of the samples of the usage of the X-ray Computed Tomography (CT)(not for examination), no factor that has a major effect on the proper usage of the X-ray Computed Tomography(CT) was found.3. The usage of the Magnetic resonance imaging (MRI) is very properThe usage of the Magnetic resonance imaging (MRI) was evaluated 184 times. In 99.5% of these evaluations, the Magnetic resonance imaging (MRI) was found to be properly used. The Magnetic resonance imaging (MRI) was found to be properly used in 40(which account for 97.6% of the total evaluations) of the 41 evaluations of the usage of the Magnetic resonance imaging (MRI) for examination. The Magnetic resonance imaging (MRI) was only improperly used (namely excessively used) 1 time, accounting for only 2.4% of the evaluations of the usage of the Magnetic resonance imaging (MRI) for examination. In 143 (which account for 100% of the evaluations) of 143 evaluations of the usage of the Magnetic resonance imaging (MRI)(not for examination), the Magnetic resonance imaging(MRI) was properly used. In 0 (which account for 0% of the evaluations) of 143 evaluations of the usage of the Magnetic resonance imaging (MRI) (not for examination), the Magnetic resonance imaging (MRI) was improperly used (namely insufficiently used. In none of 143 evaluations of the usage of the Magnetic resonance imaging (MRI) (not for examination), whether the Magnetic resonance imaging (MRI) was properly used has not been determined. Overall, the usage of the Magnetic resonance imaging (MRI), which is very proper, is more proper than the usage of the X-ray Computed Tomography (CT). The Magnetic resonance imaging (MRI) was as properly used for examination as it was used (not for examination). The Magnetic resonance imaging (MRI) is as insufficiently used as it was excessively used. Both the insufficient usage of the Magnetic resonance imaging (MRI) and the excessive usage of the Magnetic resonance imaging (MRI) were at low levels.4. The factors affecting the proper usage of the Magnetic resonance imaging (MRI)The results of the single factor analysis showed that no factor affecting the proper usage of the Magnetic resonance imaging (MRI) was found when the Magnetic resonance imaging (MRI) was not used for examination and the complexity of the disease was the factor affecting the proper usage of the Magnetic resonance imaging (MRI) when the Magnetic resonance imaging (MRI) was used for examination.5. The Analysis of the Results of the Survey on the Usage of the X-ray Computed Tomography(CT) and the Magnetic resonance imaging(MRI)The results of this survey showed that the excessive usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI) exists. This excessive usage, which was likely to be caused by some unnecessary examinations that some doctors who wanted to protect themselves asked patients to undergo, was also likely to be caused by the over-reliance of some doctors who were not very good at diagnosis through auscultation and inquiry on advanced medical examination equipment such as the X-ray Computed Tomography (CT) equipment and the Magnetic resonance imaging (MRI) machine. In addition, some patients who had blind faith in examination technologies such as the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI) took the initiative to ask for the usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI). This also contributed to the excessive usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI).This survey found that the usage of the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI) is relatively proper in spite of the excessive usage and the X-ray Computed Tomography (CT) is more insufficiently used than excessively used. This result conflicts with the prevailing view of the general public. The reason for this confliction is that the intense doctor-patient relationship in China and patients’ fading trust in doctors make the general public or some researchers believe that the large number of medical examinations is the result of the doctors’ pursuit of interests and the doctors’self-protection. [Suggestions]1. Standardizing the doctors’ behavior and reduce the excessive usageAttaching more importance to the education on ethics for doctors, improving doctors’ clinical capability, sticking to the principle of conducting medical examinations in a proper way and boycotting improper medical practice. A strict approval and reimbursement system for the usage of large medical equipment should be established. The medical insurance-management departments should not allow the costs of improper and non-standard medical examinations to be covered by medical insurance. To ensure that the general public can enjoy satisfying, safe, effective and affordable medical examination and treatment, government departments in charge of public health should strengthen their inspection of the non-standard medical examination and treatment and improper usage of medical equipment and punish violators more severely.2. Exploring to develop the Guide to the Evaluation of the Usage of Large Medical EquipmentTools for evaluating the usage of large medical equipment should be explored and established. We suggest relevant government departments develop detailed treatment guides according to different diseases and develop corresponding guides for the usage of medical equipment according to the economic development levels of different regions, the levels of hospitals and the differences of medical equipment to continuously make medical equipment used in a more proper way.3. The management of the installation of medical equipment must be strengthened to use the medical equipment in a more proper wayWhen a hospital is to purchase medical equipment, factors such as the economic development, population of the region where the hospital is located, the geographical location of the hospital and the needs for this medical equipment in that region need to be taken into account. Medical equipment need to be purchased properly according to the technical needs and usage range of different medical equipment. The mechanism for managing and limiting the use of large medical equipment and making punishments for the improper use of this equipment should be established and improved. The macro control and supervision role played by the government should be strengthened.4. Changing the improper mechanism to make large medical equipment such as the X-ray Computed Tomography (CT) and the Magnetic resonance imaging (MRI) used in a more proper wayThe experience of developed countries should be drawn to gradually adjust and better the improper policy mechanism, make medical institutions less enthuasitic in purchasing large medical equipment, reduce the incentives offered by providers of large medical equipment and to lay a foundation for the good development of hospitals and the proper purchasing of large medical equipment.5. Evaluations of the usage of large medical equipment should be conducted by using medical methods in a scientific wayA proper mechanism for evaluating the usage of large medical equipment and an evaluation standard should be established to conduct evaluations in a scientific and proper way and to make limited health care resources available to more people.