Validity Evaluation and Cost-effectiveness Analysis of CT and MRI for Diagnosis of Cerebrovascular Disease
|Course||Social Medicine and Health Management|
|Keywords||Cerebral infraction Intracerebral hemorrhage validity Cost-effectiveness analysis CT MRI|
Objective:To compare validity and cost-effective ratio of CT and MRI in diagnosis of cerebrovascular disease and to provide suggestion for selecting valid and cheaper way in clinic diagnosis.Methods:The retrospective method was used in present research.Four hospitals ranked first class on the tertiary level in Shanxi province,were surveyed.Seven hundred and twenty cases of cerebrovascular disease,were collected.①Data related to different index of the diagnostic value system to evaluate the diagnostic validity of CT and MRI.②All the cases were divided into two groups:CT group and MRI group.Cost-effectiveness ratio was calculated in our research.Cost was estimated by the actual diagnostic cost,and effectiveness was estimated by the diagnostic accuracy.A decision tree model was used to make a decision analysis on the cost-effectiveness ratio of the two strategies of cerebral infraction and intracerebral hemorrhageResults:①Fifteen percent of the cerebral infraction patients are younger than 50 years old,and 34.9% of them are over 70 years old.Prevalence rate is increasing by age.Diseases companied with cerebral infraction ranked hypertension,diabetes,cardiac disease and hyperlipemia by turns. Thirty three percent of the cases suffered from hypertension.There is no difference in the age, sex,disease area and the past history diseases.Nine percent of patient suffered from intracerebral hemorrhage are younger than 50 years old,and 91.06%of them are over 70 years old.Prevalence rate is increasing by age.Diseases companied with cerebral infraction ranked hypertension,diabetes,cardiac disease and hyperlipemia by turns.Thirteen percent of the cases suffered from hypertension.There is no difference in the age,sex,disease area and the past history diseases.②MRI has the better diagnostic accurancy in diagnosis of cerebrovascular disease by comparing to CT.③The total cost of the CT and MRI was,respectively,2320000 yuan and 4570000 yuan.The cost of CT and MRI was,respectively,326.26 yuan and 576.95 yuan for every diagnosed patient with cerebral infraction.It was 255.31 yuan and 486.27 yuan for every diagnosed patient with non-cerebral infraction patient.It was 295.88 yuan and 567.49 yuan for every diagnosed patient with intracerebral hemorrhage patient.It was 243.37 yuan and 457.82 yuan every diagnosed patient with non-intracerebral hemorrhage patient.④Sensitivity analysis shows that the research results are effected little by the parameters of the model.Conclusions:①MRI has better diagnostic accurancy than CT,so we suggest MRI should be as the first choice if not considering the cost,especially for the mini disease focus.But CT possessed better cost-effectiveness ratio than MRI for its lower price.So for diagnosing some frequent cerebrovascular disease,we suggest CT should be as the first choice.②Knowledge of cerebrovascular disease should be popular in population of over 50 years old in order to diagnose and prevent it earlier.③We should enforce the cost management of big medical equipments,improve the diffusion of them,avoid the induced need of the health providers,and transfer the exceeded consumption attitude of the patients.We should apply the two diagnostic strategies rationally to get the best diagnostic value and economic benefit.