The Effect of Advanced Diagnostic Imaging on Mortality and Length of Stay in Tehran General University Hospitals

Ebrahim Jaafaripooyan; Ali Akbarisari; Abbas Rahimiforoushani; Zahra Abedini

doi:10.18502/htaa.v4i4.6870

Ebrahim Jaafaripooyan Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Ali Akbarisari Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abbas Rahimiforoushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Zahra Abedini Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/htaa.v4i4.6870

Keywords: Advanced Diagnostic Imaging; Mortality; Length of Stay; Tehran; General Hospitals

Abstract

Background: As fast and accurate techniques, advanced medical imaging technologies (AMIT) allow healthcare professionals to better diagnose and treat various health conditions, which translates into higher use of non-invasive operational procedures. Objectives: The current study intended to investigate the effect of inpatient use of MRI and CT scan on the inpatient mortality and length of stay (LOS) in Tehran general university hospitals.

Methods: Data were collected from all general university hospitals in Tehran in 2017. A multiple linear regression model was constructed for each combination of technology and outcomes (i.e., mortality and LOS), and all models were controlled for patients’ demographic and clinical characteristics and structural profile of hospitals. In calculating hospital standardized mortality ratio (HSMR) for each of 72 diagnosis groups related to death, a binary logistic regression model was fitted with predictors including LOS, admission type, comorbidity level, sex, and age.

Results: The use of CT varied from 0.39 to 149.35, and MRI from 0.24 to 80.23 exams per 100 discharges. The HSMR ranged from 76.8% to 146%, and the average length of stay (ALOS) was 3 - 8.46 days. MRI and CT had no significant effect on the HSMR and ALOS.

Conclusions: Further use of AMIT was not linked with improved efficiency and quality but was associated with better resource management in healthcare organizations. Effective management of the AMIT use requires clear rules and regulations with assertive commitment, in addition to establishing clinical guidelines with the support of insurance companies.