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Analysis of Health Insurance Standards and Utilization of MRI in Korea: Based on Health Insurance Claim Data

한국의 MRI 건강보험 급여기준 및 진료이용에 관한 연구

  • Cho, Young-Kwon (College of health sciences, Radiologic science, Cheongju University)
  • 조영권 (청주대학교 방사선학과)
  • Received : 2018.11.05
  • Accepted : 2018.12.31
  • Published : 2018.12.30

Abstract

This study analyzed the current status of MRI (frequency, amount of treatment) based on the history of application of the MRI health insurance benefit standard and health insurance claim data. MRI examinations began as a health insurance benefit in 2005. In 2005, the indications were restricted for some diseases, but coverage for benefits in 2010, 2013, 2016, and 2018 was expanded. In 2021, the Ministry of Health and Welfare decided to apply health insurance for all MRI examinations. From 2010 to 2017, the number of MRI examinations increased by 86.7% in 2017 compared to 2010, and the amount of treatment increased by 53.5%. According to general characteristics, the number of MRI examinations was higher in women than in men. By age, the number of examinations was the highest among ages 70-79. Outpatient examinations were more frequent than inpatient examinations, and the number of examinations in the tertiary hospitals was the highest among the types of hospitals. The number of brain MRI examinations was the highest in each exam site. In December 2013, the standard of MRI was expanded for heart disease and Crohn's disease, the number of cardiac MRI and abdominal MRI examinations increased in 2014 compared to 2013. However, the number of examinations is small and not associate with the disease, it would be difficult to say that it affected the increase in the total number of MRI examinations. To assess health insurance sustainability and policy effectiveness, monitoring will be necessary.

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Fig. 1. Trend of total frequency of MRI Health Insurance Claim(2010-2017).

Table 1. Health Insurance Standard of MRI

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Table 2. Health Insurance Claim Status of MRI

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Table 4. Health Insurance Claim Status of MRI by sub exam site

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Table 3. Health Insurance Claim Status of MRI by Characteristic

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Acknowledgement

Supported by : 청주대학교

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