title: Association of hospital characteristics and diagnosis with the repeat use of CT and MRI: a nationwide population-based study in an Asian country.
abstract: OBJECTIVE
  The objective of our study was to assess the association of hospital characteristics and diagnosis with repeated utilization of CT and MRI using the nationwide population-based Taiwan National Health Insurance database.
  
  
  METHODS
  All CT and MR examinations for all health care services-including inpatient, outpatient, and emergency services-performed during 2004 and 2005 were identified. Logistic regression using generalized estimating equations was used for multivariate analysis to explore the relationships between hospital characteristics, diagnosis, and the use of CT and MRI repeated within 90 days.
  
  
  RESULTS
  A total of 2,152,292 patients underwent CT and MR examinations during the study period, and 21.5% of those patients underwent repeat scanning within 90 days. The medical center had the highest rate of repeat scanning (24.9%) followed by the regional hospital (20.4%) and community hospital (13%). Repeat CT or MRI was most commonly performed of patients with a malignancy (31.8%), a neurologic disorder (24.0%), or a brain or spinal injury (25.3%).
  
  
  CONCLUSIONS
  Our study shows that repeat use of CT and MRI within 90 days is high and is related to both diagnosis and hospital characteristics. Although the Taiwanese experience might not apply to all countries, this knowledge should aid in the review of health care policies so that guidelines for repeat scanning may be tailored to the different levels of hospitals (medical centers, 25%; regional hospital, 20%; community hospital, 13%) and to different diseases (malignant neoplasms, 32%; neurologic disorders and brain, neck, or spinal injury, 25%; other entities, 20%) to achieve maximum efficiency within a limited health care budget.
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
authors.forename: Dachen
authors.initials: D
authors.lastname: Chu
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.forename: Tom
authors.initials: T
authors.lastname: Chen
authors.forename: Sheng-Tzu
authors.initials: ST
authors.lastname: Hung
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006302:Health Services Research; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013624:Taiwan; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*