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J Korean Soc Emerg Med > Volume 34(3); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(3): 267-275.
응급실에 내원한 어지럼 환자에서 급여 기준 변화가 뇌 MRI 이용 빈도에 미치는 영향
최시온 , 변준섭 , 최수복 , 김총명 , 하철민 , 이형주 , 정영윤
한일병원 응급의학과
The effect of changes in reimbursement coverage on the number of brain MRI scan in patients with dizziness in the emergency department
Zion Choi , June-Seob Byun , Soo-bok Choi , Chong-Myeong Kim , Chul-Min Ha , Hyoung-Ju Lee , Young-Yun Jung
Department of Emergency Medicine, Hanil General Hospital, Seoul, Korea
Correspondence  June-Seob Byun ,Tel: 02-901-3008, Fax: 02-901-3004, Email: 19510024@hanilmed.net,
Received: July 14, 2022; Revised: September 5, 2022   Accepted: September 13, 2022.  Published online: June 30, 2023.
ABSTRACT
Objective:
This study examined whether the changes in reimbursement coverage of brain magnetic resonance image (MRI) affected practice for patients who visited the emergency department with dizziness as the chief complaint.
Method:
Among the 5,423 patients who visited the emergency department for dizziness in 2017, 2019, and 2021, 4,497 patients were included in the study retrospectively and investigated by brain diffusion-weighted MRI and the presence of cerebral infarction on brain diffusion-weighted MRI. This study examined whether there was a significant difference before and after the change.
Results:
In 2017, 2019, and 2021, 1,489, 1,570, and 1,438 patients with dizziness visited the emergency department, respectively. The number of patients who underwent a brain MRI scan gradually increased from 237 (15.9%) in 2017 to 628 (40.0%) in 2019 and 948 (65.9%) in 2021 (P<0.001). The number of positive findings on brain MRI scan increased gradually from 30 patients (2.0%) in 2017 to 47 patients (3.0%) in 2019 and 53 patients (3.7%) in 2021 (P=0.025). The ratio of positive findings of brain MRI scans to the number of patients who underwent brain MRI scans decreased gradually to 12.7% in 2017, 7.5% in 2019, and 5.6% in 2021 (P=0.001).
Conclusion:
The changes in the reimbursement coverage of brain MRI affect the number of brain MRI scans and the detection of cerebral infarction.
Key words: Dizziness; Emergency department; Magnetic resonance imaging; Insurance; Stroke
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