Diferentes instrumentos para adecuar la demanda de la tomografía computarizada y la resonancia magnética

Abstract

Diagnostic tests are a very important element in ensuring the quality of health care provided as they make, essential on occasions, a contribution to the improvement of diagnostic accuracy, and with this, therapeutic decisions. Technological development, the increased possibilities of diagnostic tests, and the growing demand for those by society means that equipment, and therefore, the number of studies carried out has grown considerably. This increased use of high technology diagnostic tests in the last few years has generated an imbalance between their supply and demand. Several studies have also pointed to the inadequate use of the most sophisticated diagnostic tests. Using a review of the scientific and grey literature, a search was made for detailed information on the variability in the provision and the requests made as regards magnetic resonance imaging (MRI) and computed axial tomography (CAT), as well as real and recommended waiting times. Strategies developed by different organisations to try to manage demand were also searched for: tools for the clinical prioritisation of patients, tools to improve the indication for use, and for assessing the appropriate use of these tests. To correct the imbalance created by the supply and demand, it seems that different strategies need to be developed and applied to influence both binomials of the equation. The strategies applied should take into account methods that have shown to be more effective in changing clinical practice, as well as those elements associated with the health context in which they have been developed.