Overuse of Radiological Imaging in National Health Insurance Fund Centres, Khartoum Sudan 201

Abstract

Background: Overuse of radiological imaging contributed to risk of radiation.

Objective: To identify causes of overuse and unnecessary radiological imaging and the responses of radiologist towards doubtful imaging requests.

Methods: A cross sectional study carried out in four reference diagnostic centres accepting insured patients. Self-administered questionnaire was testing the perception of radiologists by Likert scale. Eleven and five causes were listed for overuse and unnecessary imaging respectively. Factor analysis was used to extract the domain causes. Cronbach's Alpha was used for reliability at >0.7.  Fisher exact test was used at 95% confidence level to test the association of the cause, insufficient clinical examination, with time being working in NHIF and the working years. 

Results:

Females accounted to 71.4%, 48.4% were specialists of Computed tomographic scan and paediatric radiology. Perceived causes of overuse were new radiological technology (71.4%), availability of radiological resources (57.1%), larger payment from NHIF (57.1%) and patients` demands (57.1%). Factor analysis yielded five causes of overuse. Insufficient clinical examination (90.4%) and give comfort to the patients (61.9%) were causes of unnecessary imaging. Doubtful imaging request was not performed because of serious complications of radiation (71.4%). The cause, insufficient clinical examination was not significantly associated with time being working in NHIF and the working years P-value > 0.05. 

Conclusion:

Insufficient clinical examination and comfort the patients were the causes of unnecessary radiology imaging .Radiologists did not respond to doubtful imaging request for the serious complications of radiation.