Evaluation of the Amount of Appropriate Medical Imaging Administration: Evidence Related to Existing Causes and Solutions

Diagnostic and curative services are a major source of healthcare expenditures, indicating their potential to control such expenditures. This study aimed to evaluate appropriateness of medical imaging services and to provide policy options to address this challenge.

Following a systematic review design, international (Elsevier, PubMed, Web of Science, and Scopus) and national (IranMedex, MagIran and SID) databases were searched from 1990 to November, 2021 using various combinations of the following keywords: Diagnostic imaging/Radiology, Medical Imaging, CT-Scan, Rational consumption, appropriateness, Health service misuse/Medical overuse, and services utilization. Google Scholar was also mined. STROBE checklist was used to evaluate the quality of articles.

Initially 605 articles were found, of which 22 were found as eligible. All studies mention various levels of inappropriateness of services (i.e., 21 to 76%), and mentioned different causes, including benefiting from complementary health insurance coverage, insufficient knowledge of providers, and various referrals of patients. The most widely mentioned solutions include training providers and establishment of a strong monitoring systems.

Inappropriateness of prescribed results in increased burden for health systems, health insurance funds, and providers. Also, this problem is not restricted to Iran and several high income countries with well-established health systems are also faced with this problem.