Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs
Objectives The objective of this study is to investigate the proportion of potentially low-value knee MRI in Norway and to provide an estimate of the related costs.Design Register study based on conditional data extraction and analysis of data from Control and Reimbursement of Healthcare Claims regi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/3/e081860.full |
| _version_ | 1797262806109650944 |
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| author | Bjørn Hofmann Elin Kjelle Eivind Richter Andersen Vegard Håvik Ingrid Øfsti Brandsæter |
| author_facet | Bjørn Hofmann Elin Kjelle Eivind Richter Andersen Vegard Håvik Ingrid Øfsti Brandsæter |
| author_sort | Bjørn Hofmann |
| collection | DOAJ |
| description | Objectives The objective of this study is to investigate the proportion of potentially low-value knee MRI in Norway and to provide an estimate of the related costs.Design Register study based on conditional data extraction and analysis of data from Control and Reimbursement of Healthcare Claims registry in Norway.Setting MRI in public specialist healthcare with universal health coverage (Norway).Participants 48 212 MRIs for 41 456 unique patients and 45 946 reimbursement claims.Outcome measures Proportion of MRIs of the knee that (1) did not have a relevant tentative diagnosis prior to the knee MRI, (2) did not have a relevant alternative image of the knee before the MRI or (3) did not have a relevant code from the specialist care within 6 months after the MRI, and those that had combinations of 1, 2 and 3. Estimated costs for those that had combinations of 1, 2 and 3.Results Very few patients (6.4%) had a relevant diagnosis code or prior imaging examination when having the MRI and only 14.6% got a knee-related diagnosis code from the specialist care within 6 months after the MRI. 21.8% of the patients had knee X-ray, CT or ultrasound within 6 months before the MRI. Between 58% and 85% of patients having knee MRIs in Norway have no relevant examinations or diagnoses six months prior to or after the MRI examination. These examinations are unlikely to benefit patients and they correspond to between 24 108 and 35 416 MRIs at a cost of €6.7–€9.8 million per year.Conclusion A substantial proportion of MRIs of the knee in Norway have no relevant examinations or diagnoses before or after the MRI and are potentially of low value. Reducing low-value MRIs could free resources for high-value imaging, reduce waiting times, improve the quality of care and increase patient safety and professional integrity. |
| first_indexed | 2024-04-25T00:02:58Z |
| format | Article |
| id | doaj.art-a7df9ae59f8f4ce4a8ac156d32628ca4 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-25T00:02:58Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-a7df9ae59f8f4ce4a8ac156d32628ca42024-03-14T06:20:08ZengBMJ Publishing GroupBMJ Open2044-60552024-03-0114310.1136/bmjopen-2023-081860Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costsBjørn Hofmann0Elin Kjelle1Eivind Richter Andersen2Vegard Håvik3Ingrid Øfsti Brandsæter44 Department of Health Science, Norwegian University of Science and Technology, Gjøvik, Norway1Norwegian University of Science and Technology, Gjøvik, Norway1Norwegian University of Science and Technology, Gjøvik, NorwayDepartment for Medical Reimbursement, Norwegian Directorate of Health, Oslo, NorwayDepartment of Health Sciences in Gjøvik, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Gjøvik, NorwayObjectives The objective of this study is to investigate the proportion of potentially low-value knee MRI in Norway and to provide an estimate of the related costs.Design Register study based on conditional data extraction and analysis of data from Control and Reimbursement of Healthcare Claims registry in Norway.Setting MRI in public specialist healthcare with universal health coverage (Norway).Participants 48 212 MRIs for 41 456 unique patients and 45 946 reimbursement claims.Outcome measures Proportion of MRIs of the knee that (1) did not have a relevant tentative diagnosis prior to the knee MRI, (2) did not have a relevant alternative image of the knee before the MRI or (3) did not have a relevant code from the specialist care within 6 months after the MRI, and those that had combinations of 1, 2 and 3. Estimated costs for those that had combinations of 1, 2 and 3.Results Very few patients (6.4%) had a relevant diagnosis code or prior imaging examination when having the MRI and only 14.6% got a knee-related diagnosis code from the specialist care within 6 months after the MRI. 21.8% of the patients had knee X-ray, CT or ultrasound within 6 months before the MRI. Between 58% and 85% of patients having knee MRIs in Norway have no relevant examinations or diagnoses six months prior to or after the MRI examination. These examinations are unlikely to benefit patients and they correspond to between 24 108 and 35 416 MRIs at a cost of €6.7–€9.8 million per year.Conclusion A substantial proportion of MRIs of the knee in Norway have no relevant examinations or diagnoses before or after the MRI and are potentially of low value. Reducing low-value MRIs could free resources for high-value imaging, reduce waiting times, improve the quality of care and increase patient safety and professional integrity.https://bmjopen.bmj.com/content/14/3/e081860.full |
| spellingShingle | Bjørn Hofmann Elin Kjelle Eivind Richter Andersen Vegard Håvik Ingrid Øfsti Brandsæter Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs BMJ Open |
| title | Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs |
| title_full | Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs |
| title_fullStr | Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs |
| title_full_unstemmed | Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs |
| title_short | Low-value MRI of the knee in Norway: a register-based study to identify the proportion of potentially low-value MRIs and estimate the related costs |
| title_sort | low value mri of the knee in norway a register based study to identify the proportion of potentially low value mris and estimate the related costs |
| url | https://bmjopen.bmj.com/content/14/3/e081860.full |
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