An Evaluation on Medical Device Usage Status: A Study on Turkey and European Union Countries

Yıl 2021, , 381 - 398, 25.12.2021

Gülnur İlgün , Seda Sönmez , Gülsüm Koca

https://doi.org/10.18070/erciyesiibd.874217

Öz

In this study, Turkey and the European Union (EU) member states in imaging used for computed tomography (CT) and magnetic resonance imaging (MRI) to calculate the rate of use of devices and operating margin per device, and the country is intended to classify according to these variables. Within the scope of the research, firstly, device usage rates and usage shares per device were calculated. Countries were then grouped separately by hierarchical clustering analysis in terms of usage rates and shares for both CT and MRI devices. The results of the calculations for Turkey in order CT and MRI utilization rate of 20.87 and 32.84 while the EU average was found to be 3.44 and 2.92. According to the cluster analysis results, in terms of IT device, France and Turkey in the first group, other countries in second group; In terms of the MRI device, Spain, France, the United Kingdom and Turkey in the first group, other countries in second group. It is thought that the results obtained from the study will provide important evidence-based information in the planning of health services to be provided through health technologies, in determining the number of devices, and in making decisions regarding the efficient use of devices.

Anahtar Kelimeler

CT, MRI, Rate Of Use, Share of Device Usage, Cluster Analysis

Tıbbi Cihaz Kullanım Durumunun Değerlendirilmesi: Türkiye ve Avrupa Birliği Ülkeleri Üzerine Bir Araştırma

Öz

Bu çalışmada Türkiye ve Avrupa Birliği (AB) üyesi ülkelerde görüntüleme amaçlı kullanılan bilgisayarlı tomografi (BT) ile manyetik rezonans görüntüleme (MRG) cihazlarının kullanım oranlarını ve cihaz başına kullanım paylarını hesaplamak ve bu değişkenlere göre ülkeleri sınıflamak amaçlanmıştır. Araştırma kapsamında ilk olarak cihaz kullanım oranları ve cihaz başına kullanım payları hesaplanmıştır. Ardından, ülkeler hem BT hem de MRG cihazı için kullanım oranları ve payları açısından ayrı ayrı hiyerarşik kümeleme analiziyle gruplandırılmıştır. Yapılan hesaplamalar sonucunda BT ve MRG kullanım oranlarının sırayla Türkiye için 20,87, 32,84 ve AB ortalamalarının ise 3,44, 2,92 olduğu bulunmuştur. Kümeleme analizi sonucunda ise, BT cihazı açısından, Fransa ve Türkiye’nin birinci grupta diğer ülkelerin ikinci grupta; MRG cihazı açısından ise İspanya, Fransa, Birleşik Krallık ve Türkiye’nin birinci grupta diğer ülkelerin ikinci grupta yer aldığı bulunmuştur. Çalışmadan elde edilen sonuçların sağlık teknolojileri aracılığıyla sunulacak olan sağlık hizmetlerinin planlanmasında, cihaz sayılarının belirlenmesinde, cihazların verimli kullanımına ilişkin kararların alınmasında kanıta dayalı önemli bilgiler sunacağı düşünülmektedir

Anahtar Kelimeler

BT, MRG, Kullanım Oranı, Cihaz Balı Kullanım Payı, Kümeleme Analizi

Kaynakça

• Agha, L. (2014). The effects of health information technology on the costs and quality of medical care. Journal of Health Economics, 34, 19-30.
• Baris, E., Mollahaliloglu, S., ve Aydin, S. (2011). Healthcare in Turkey: from laggard to leader. BMJ, 342, c7456.
• Black, W. C., ve Welch, H. G. (1993). Advances in diagnostic imaging and overestimations of disease prevalence and the benefits of therapy. New England Journal of Medicine, 328(17), 1237-1243.
• Brenner, D. J., ve Hall, E. J. (2007). Computed tomography—an increasing source of radiation exposure. New England Journal of Medicine, 357(22), 2277-2284.
• Broder, J., ve Warshauer, D. M. (2006). Increasing utilization of computed tomography in the adult emergency department, 2000–2005. Emergency Radiology, 13(1), 25-30.
• Chevreul, K., Brigham, B., Durand-Zaleski, I., ve Hernández-Quevedo, C. (2015). France: Health system review. Health Systems in Transition, (17/3). Copenhagen, Denmark: World Health Organization Puplication.
• Cinaroglu, S., ve Baser, O. (2017). Spatial distribution of total number of medical devices in Turkey: A classification analysis. International Journal of Medicine and Public Health, 7(2), 102-106.
• Dieleman, J. L., Campbell, M., Chapin, A., Eldrenkamp, E., Fan, V. Y., Haakenstad, A., ... Reynolds, A. (2017). Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. The Lancet, 389(10083), 2005-2030.
• Dinan, M. A., Curtis, L. H., Hammill, B. G., Patz, E. F., Abernethy, A. P., Shea, A. M., ve Schulman, K. A. (2010). Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999-2006. JAMA, 303(16), 1625-1631.
• Doi, K. (2006). Diagnostic imaging over the last 50 years: research and development in medical imaging science and technology. Physics in Medicine ve Biology, 51(13), R5-R27.
• Emery, D. J., Shojania, K. G., Forster, A. J., Mojaverian, N., ve Feasby, T. E. (2013). Overuse of magnetic resonance imaging. JAMA Internal Medicine, 173(9), 823-825.
• Erus, B., ve Aktakke, N. (2012). Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees. The European Journal of Health Economics, 13(3), 337-346.
• Etard, C., Aubert, B., ve Sinno-Tellier, S. (2010). Medical exposure of the French population in 2007. In Third European IRPA Congress, Radiation and Nuclear Safety Authority, Finland, Helsinki, FIN (pp. 239-243).
• Eurostat (2019, June 16). https://appsso.eurostat.ec.europa.eu/nui/submitViewTableAction.do
• Giger, M. L., Karssemeijer, N., ve Armato, S. G. (2001). Computer-aided diagnosis in medical imaging. IEEE Trans. Med. Imag, 20, 1205–1208.
• Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., ve Taylor, R. (2005). Can electronic medical record systems transform health care? Potential health benefits, savings, and costs. Health affairs, 24(5), 1103-1117.
• Kantaris, M., Theodorou, M., Angelopoulos, G., ve Kaitelidou, D. (2017). CTs and MRIs in Cyprus: A market analysis. Nursing Care & Research/Nosileia kai Ereuna, (48), 112-127.
• Lai, T., Habicht, T., Kahur, K., Reinap, M., Kiivet, R., ve van Ginneken E. (2013). Estonia: health system review. Health Systems in Transition, 15(6), 1–196.
• Levin, D. C., Spettell, C. M., Rao, V. M., Sunshine, J., Bansal, S., ve Bushee, G. R. (1998). Impact of MR imaging on nationwide health care costs and comparison with other imaging procedures. AJR. American journal of roentgenology, 170(3), 557-560.
• Matin, A., Bates, D. W., Sussman, A., Ros, P., Hanson, R., ve Khorasani, R. (2006). Inpatient radiology utilization: trends over the past decade. American Journal of Roentgenology, 186(1), 7-11.
• Medicare Payment Advisory Commission, ve Book, A. D. (2012). Healthcare spending and the Medicare program. Washington, DC: MedPAC.
• Miglioretti, D. L., ve Smith-Bindman, R. (2011). Overuse of computed tomography and associated risks. Am Fam Physician, 83(11), 1252-1254.
• Organisation for Economic Co-operation and Development (OECD) (2019, May 5). Magnetic resonance imaging (MRI) exams (indicator). Doi: 10.1787/1d89353f-en.
• Parker, L., Levin, D. C., Frangos, A., ve Rao, V. M. (2010). Geographic variation in the utilization of noninvasive diagnostic imaging: national Medicare data, 1998–2007. American Journal of Roentgenology, 194(4), 1034-1039.
• Perez, F. A., ve Jarvik, J. G. (2012). Evidence-based imaging and effective utilization: lessons in neuroradiology. Neuroimaging Clinics, 22(3), 467-476.
• Rao, V. M., ve Levin, D. C. (2012). The overuse of diagnostic imaging and the Choosing Wisely initiative. Annals of Internal Medicine, 157(8), 574-576.
• Rohaya, M. N. (2011). Medical imaging trends and implementation: Issues and challenges for developing countries. Journal of Health Informatics in Developing Countries, 5(1), 89-98.
• Smith-Bindman, R., Miglioretti, D. L., ve Larson, E. B. (2008). Rising use of diagnostic medical imaging in a large integrated health system. Health Affairs, 27(6), 1491-1502.
• Smith-Bindman, R., Miglioretti, D. L., ve Larson, E. B. (2008). Rising use of diagnostic medical imaging in a large integrated health system. Health Affairs, 27(6), 1491-1502.
• Smith-Bindman, R., Miglioretti, D. L., Johnson, E., Lee, C., Feigelson, H. S., Flynn, M., ... Solberg, L. I. (2012). Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA, 307(22), 2400-2409.
• Sodickson, A., Baeyens, P. F., Andriole, K. P., Prevedello, L. M., Nawfel, R. D., Hanson, R., ve Khorasani, R. (2009). Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology, 251(1), 175-184.
• Sonğur, C., ve Top, M. (2016). Regional clustering of medical imaging technologies. Computers in Human Behavior, 61, 333-343.
• Tatar, M., ve Kanavos, P. (2006). Health care reform in Turkey. Eurohealth, 12(1), 20-22.
• Vasilescu, L., Faller, M., ve Allou, A. (2018). PHP225-Assessment of the Unit Costs in Imaging Acts: The Example of MRI and CT-Scan Acts in France. Value in Health, 21, S188.
• World Health Organization (WHO). (2010). Medical Devices: Managing the mismatch an outcome of the priority medical devices project. Switzerland: World Health Organization Puplication.
• Wilkinson, G., ve Drummond, M. (2014). Impact of reimbursement policies on the adoption of medical devices in an outpatient setting. Health Policy and Technology, 3(4), 281-286.
• Winter, L., Pellicer-Guridi, R., Broche, L., Winkler, S. A., Reimann, H. M., Han, H., ... Ettinger, K. M. (2019). Open Source Medical Devices for Innovation, Education and Global Health: Case Study of Open Source Magnetic Resonance Imaging. In Co-Creation (pp. 147-163). Springer, Cham.
• Yardim, M. S., ve Uner, S. (2018). Equity in access to care in the era of health system reforms in Turkey. Health Policy, 122(6), 645-651.