Korean radiologists read 336 test images per month on average

Korea’s first government evaluation of medical imaging tests found that 1,694 institutions submitted about 3.29 million claims, totaling 554.3 billion won ($400.2 million), for CT, MRI, and PET scans performed between July and September 2023.

Among the institutions that submitted claims, about 83 percent had radiologists on staff, with each radiologist reviewing an average of 336 cases per month.

The Health Insurance Review and Assessment Service (HIRA) recently released the “2023 (1st) Appropriateness Evaluation Results for Imaging Tests,” which contained various related information.

The evaluation was conducted to enhance patient safety regarding radiation exposure and contrast agent side effects, and to improve the quality of imaging tests in situations where scientific diagnostic methods, including radiological imaging, have become widespread and the use of medical radiation for diagnosis and treatment continues to increase.

The evaluation covered medical services provided from July to September 2023, targeting medical institutions at the clinic level or higher that owned at least one CT (computed tomography) scanner, MRI (magnetic resonance imaging) scanner, or PET (positron emission tomography) scanner and billed for imaging tests during the evaluation period. The target patients included inpatients and outpatients who underwent CT, MRI, or PET imaging tests.

According to the evaluation results, 1,694 institutions billed for examinations using the evaluated equipment, with about 3.29 million claims and a total claim amount of about 554.3 billion won.

By equipment type, CT was billed by 1,519 institutions for 2,624,694 cases, averaging 1,728 cases per institution, with a total billing amount of 348.3 billion won, accounting for 62.9 percent of the total billing amount.

MRI was billed by 1,179 institutions for 605,753 cases, averaging 514 cases per institution, with a total claim amount of 183.6 billion won, accounting for 33.1 percent of the total claim amount. PET was billed by 124 institutions for 58,038 cases, averaging 468 cases per institution, with a total claim amount of 22.2 billion won, accounting for 4.0 percent of the total claim amount.

When examining the status of radiologists at each institution, it was found that 83.8 percent of all CT and MRI claim institutions have radiologists on staff. By type, tertiary general hospitals had 45 out of 45 claim institutions with radiologists, representing 100 percent, and general hospitals also had 326 out of 326 claim institutions with radiologists, representing 100 percent.

Also, 687 out of 770 hospitals had radiologists, accounting for 89.2 percent; 355 out of 539 clinics had radiologists, accounting for 65.9 percent; three out of seven mental hospitals had radiologists, accounting for 42.9 percent; and nursing hospitals had one out of four institutions, accounting for 25.0 percent.

Accordingly, it was confirmed that each radiologist read an average of 336.5 CT and MRI scans per month. By type of medical institution, tertiary general hospitals read 409.4 scans, general hospitals read 427.0 scans, hospitals read 203.4 cases, mental hospitals read 10.8 cases, and clinics read 130.0 cases.

Additionally, 111 out of 124 PET claim institutions had nuclear medicine specialists, representing 89.5 percent.

Regarding equipment status, the average number of devices per institution ranged from 1.3 to 1.5. By device type, CT scanners were owned by 1,522 institutions, comprising a total of 2,217 units; MRI scanners were owned by 1,202 institutions, totaling 1,863 units; and PET scanners were owned by 129 institutions, totaling 172 units.

Regarding the number of scans per CT and MRI device, the average number of scans per CT device per month was 507.5, with tertiary general hospitals having the highest number at 1,286.7 scans. For MRI, the average number of scans per device per month was 228.9, with tertiary general hospitals again having the highest number at 713.2.

Regarding the usage of contrast agents, the proportion of CT and MRI scans using contrast agents was 50.5 percent and 47.2 percent, respectively, with higher usage at general hospitals and above.

When examining claims by gender and age, there was no significant difference by gender; however, by age, those in their 60s accounted for the highest percentage at 25.0 percent. When examining claims by examination site, CT scans of the abdomen accounted for 35.0 percent, MRI scans of blood vessels accounted for 35.1 percent, and PET scans of the torso accounted for 84.5 percent, respectively, as the most frequently imaged areas.

Regarding safety-related indicators, the results of a survey on the use of dose management programs for CT scans showed that only 8.6 percent (125 out of 1,461 facilities) were using such programs. Additionally, the rate of radiation safety managers conducting radiation safety education for medical staff and physicians within healthcare facilities was 68.8 percent.

Based on these evaluation results, comprehensive scores and evaluation grades were assigned. Among the 1,694 facilities evaluated, 492 (29.0 percent) received a grade of 1. By type, 100 percent of tertiary general hospitals, 57.4 percent of general hospitals, 20.4 percent of hospitals, 18.9 percent of clinics, and 14.3 percent of mental hospitals received a grade 1, while none of the nursing hospitals did so.

HIRA has begun reviewing and improving the evaluation indicators since early this month, and the schedule for the second evaluation has not yet been finalized.