Analyzing inappropriate magnetic resonance imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain

Int J Health Plann Manage. 2019 Oct;34(4):e1437-e1447. doi: 10.1002/hpm.2806. Epub 2019 Jul 4.

Abstract

Introduction: Back pain is a common global disorder and magnetic resonance imaging (MRI) is one method of assessing its cause. The lack of official and general clinical guidelines is the cause of inadequate supervision of lumbar MRI prescriptions. The goal of this research was to analyze inappropriate lumbar MRI prescriptions and the resulting economic burden on individuals.

Method: This is a descriptive-analytical study carried out on a sample of 614 patients who visited four hospitals in Tehran. The appropriateness or inappropriateness of the MRI prescriptions was determined using clinical guidelines and a questionnaire based on previous studies. The economic burden created by inappropriate prescriptions for MRIs was determined after calculating the total direct and indirect costs.

Findings: The total MRI prescription cost paid by the study sample was $26 071, and the cost of inappropriate prescriptions was $10 310. The MRI prescription rate had a significant relationship with gender, age, education, employment, primary insurance type, and supplemental health insurance.

Conclusion: The research findings revealed relatively high rates of inappropriate MRI prescriptions in the private and public sectors. Hence, policymakers should design, create, and develop clinical guidelines and enforce the policies and rules to decrease inappropriate MRI prescriptions.

Keywords: economic burden; inappropriate prescription; lumbar disorders; magnetic resonance imaging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Back Pain / diagnostic imaging*
  • Back Pain / economics
  • Cost of Illness
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Lumbosacral Region / diagnostic imaging
  • Magnetic Resonance Imaging / economics
  • Magnetic Resonance Imaging / statistics & numerical data*
  • Male
  • Middle Aged
  • Unnecessary Procedures / economics
  • Unnecessary Procedures / statistics & numerical data*