Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran

Mohammadreza  Kalantarhormozi; Ahmad  Yazdanpanah; Mohammadreza  Yazdankhahfard; Batool  Amiri; Reza  Nemati; Milad  Sohrabi Shekafti; Hedayat  Salari; Atefeh  Esfandiari

doi:10.18502/jebhpme.v6i2.9939

Mohammadreza Kalantarhormozi The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
Ahmad Yazdanpanah Department of Ophthalmology, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Mohammadreza Yazdankhahfard Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
Batool Amiri Clinical Research Development Unit,The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
Reza Nemati Neurology Department, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Milad Sohrabi Shekafti Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Hedayat Salari Department of Health Policy & Management, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
Atefeh Esfandiari Department of Health Policy & Management, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

DOI: https://doi.org/10.18502/jebhpme.v6i2.9939

Keywords: MRI, Brain, Appropriateness, Clinical guidelines, Headache

Abstract

Background: The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021.

Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021.

Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value < 0.050.

Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.