La Radiologia medica
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La Radiologia medica · Oct 2004
Magnetic resonance imaging of the upper airway in obstructive sleep apnea.
To define the role and reliability of MR imaging of the oropharynx during wakefulness in the evaluation of patients with Obstructive Sleep Apnoea Syndrome. ⋯ In patients with a clinical diagnosis of OSAS, MR imaging performed during wakefulness can provide reliable information on the causes, severity and site/s of oropharyngeal obstruction with important consequences on therapeutic decisions.
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La Radiologia medica · Oct 2004
Comparative StudyComparison between indicators for the measurement of radiology activity volumes (Italy-USA).
Different evaluation systems and indicators have recently been used to measure the activity volumes of Italian hospital departments, and in particular of Diagnostic Imaging Units. These measurements have mostly been based on more or less complex and repeatable indicators such as total accesses, accesses per imaging modality, type and number of exams. The aim of this study was to compare four models for measuring and evaluating productivity to assess their features and propose a common method for measuring activity volumes in a Diagnostic Imaging Unit. The models considered are: a) the numerical count, b) the model proposed by SNR-SAGO-SIRM, c) the model based on transfer prices in use in the Emilia Romagna Region (RER), d) the model used by the U.S. Health Care Financing Agency (HCFA-USA), based on a complex system of weights named RVUs (Relative Value Units). ⋯ Based on the numerical count, conventional radiology and ultrasound play a predominant role (40% and 34%, respectively, total 74%). This approach therefore fails to reflect the weight of more technologically advanced procedures. The SNR-SAGO-SIRM model gives adequate importance to the combination ''number- weight of patients'' among the macroaggregates analysed. The RER model rewards the use of more expensive technologies, as it assesses the overall weight of the service and not only the weight of the radiologist's activity. The RVU model, with its distribution of weights, differentiates the different work, cost, and insurance components of the macroaggregates. It also introduces an important aspect that is new to our professional and scientific culture: evaluation of the ''insurance component'', whose role will become increasingly important in Italy. The difficulty index (work-RVUs/no. of procedures), which expresses the ratio between the number of modalities and their complexity, is particularly interesting. This index, adjusted to reflect the Italian situation, might help to assess the true technological and scientific content of the department's activity.