The effect of advanced diagnostic imaging on mortality and length of stay in Tehran general university hospitals

Abstract Background: Advanced medical imaging technologies (AMIT) are greatly associated with the pace, accuracy and ability of physicians to better diagnose and treat various diseases, and boost the possible potential of non-invasive operational procedures. Accordingly, this study aims to investigate inpatient use of MRI and CT and the effect of their use on inpatient mortality and length of stay (LOS) in Tehran general university hospitals. Methods: The study gathered its data from all general university hospitals in Tehran in 2017. Analysis unit was hospital. Multiple linear Regression model was constructed for each combination of technology and outcomes (mortality and LOS), and all models were Controlled for patients’ demographic and clinical characteristics and structural characteristics of hospital. In calculating Hospital standardized mortality ratio (HSMR) for each of seventy two diagnosis groups related to death, a Binary logistic regression model was fitted with predictors including LOS, admission type, comorbidity level, sex, and age. Results: The use of CT varied from 0.39 to 149.35, and MRI from 0.24 to 80.23 exams per 100 discharges. The HSMR ranged from 76.8 percent to 146 percent and, the average length of stay (ALOS) from 3 to 8.46 days. The use of MRI and CT had no significant effect on the HSMR and ALOS in the studied hospitals. Conclusions: Further use of AMIT has not improved efficiency and quality in health care. This research indirectly assessed the appropriateness of MRI and CT services in the studied hospitals, and it is possible that inappropriate and unnecessary use of these services affected the results. Better management of the use of AMIT requires clear rules and regulations with assertive commitment, in addition to establishing clinical guidelines with the support of insurance companies.