CT检查中的过度使用研究

目的，证实并定量分析大型医用设备利用中的过度使用情况，为制定医疗保险政策和CT配置规划提供参考。方法：使用前瞻性的Expert Panel方法对利用CT的患者进行适宜性评价，得到过度使用的水平，使用Logistic和Probit模型对影响过度使用的因素进行分析。结果：研究证实在利用CT的患者中有一定比例的利用是不必要的，占总量的16．3％，计量分析结果表明，影响过度使用的主要原因是医疗机构和医疗保险因素。前瞻性的同行专家评的结果显示，在CT利用中有一部分可以使用其他普通的检查来替代而不影响诊断质量。结论：诱导需求和道德损害存在于大型医用设备的利用中，必须采取措施减少不必要的检查，防止卫生资源的浪费。

Study on the Overuse in CT Scan

The objectives of this study are to justify and measure the over use in the utilization of high - tech medical devices and provide information for decision - making in health insurance scheme and CT planning. Methods: Prospective expert panel method was employed to assess the appropriateness fo the demand for CT scan. From this approach, over use was drawn. Probit model was used to analyze the factors, which affect over use in CT scan. Results: The expert pannel results revealed that the existence of over use in CT scans. The over use occupied 16. 3% of the total scan. Quantitative analysis showed that the main factors that affected the over use were medical institution and health insurance coverage status. Expert panel showed that there was substitution effects in the utilization of CT, which meant some examination in CT scan could be replaced by ordinary medical devices without the examination quality reduced. Conclusions: Supplier - induced demand and moral hazard do exist in the utilization of high - tech medical devices. Prospective expert panel is a good approach for studying over use. Options and measures should be taken to reduce the over use to avoid waste of health resources.