Computed Tomography Spending and Utilization for Inpatients with Cerebral Infarction in South Korea

Abstract

Background: Computed tomography (CT) is one of the most efficient diagnostic methods for stroke patients. The number of CT scanners in South Korea, however, is higher than in other countries, and may cause the overuse of this tool in healthcare. We aim to study the relationship between using CT and various patient and hospital characteristics among patients with cerebral infarction. Methods: We analyzed nationwide health insurance claims data for patients due to cerebral infarction during the second half of 2013 for up to 3 months. We performed multilevel analysis, including both inpatient and hospital-level variables, to determine how factors affect CT spending and utilization. Results: The data used in our study consisted of 17,046 hospitalizations at 583 hospitals. Inpatients who visited more than one hospital had higher CT utilization numbers and cost (number: ≥3 hospitals: β, 2.27; p <0.05; 2 hospitals: β, 0.70; p <0.05; cost: ≥3 hospitals:β, 251,108; p <0.05; 2 hospitals: β, 77,299; p <0.05). People who visited a general hospital had higher numbers and cost of CT utilization than people who visited a smaller hospital. Conclusion: Increased sharing of records and improved continuity of care between hospitals are needed to help curb the overuse of CT.