Myocardial perfusion scintigraphy in Taiwan from 2005 to 2009

Abstract

To analyze the utilization of myocardial perfusion scintigraphy (MPS) in Taiwan within the universal healthcare system, the National Health Insurance (NHI) from 2005 to 2009, and to compare with European surveys. On the basis of Taiwan's National Health Insurance Research Database of 2005-2009, a retrospective population-based analysis was conducted. Descriptive statistics were provided on the frequencies of and distributions in the utilization of MPS during the period. In addition, correlation analysis was applied to identify correlated factors in the utility of MPS. The annual number of MPS procedures performed was estimated to be 76 448 on average in 2005-2009 and 3361 per million population (pmp) over the period. The frequency increased by 45%, from 3008 pmp in 2005 to 4371 pmp in 2009, with an annual increase rate of 11.9%. The expenditure on MPS increased by 51%, from 12.3 million USD in 2005 to 18.55 million USD in 2009, with an annual increase rate of 12.9%. The average cost of identifying a coronary artery disease (CAD) case with MPS was 248 USD, with a 2.6% annual increase rate. Most patients were more than 50 years old when they received the MPS examination, whereas inpatients were much older. In addition, most of the MPS practices were performed in medical centers and regional hospitals, although an apparent increase was seen in district hospitals on outpatients. As a consequence, the rate of CAD diagnoses by MPS decreased over time. The numbers, frequencies, and expenses of MPS practices have increased in Taiwan during the period 2005-2009, especially for outpatients. The application rate of MPS in Taiwan was higher than that in Europe, likely because of the high accessibility to MPS procedures within the NHI system. This experience in Taiwan may serve as a reference for illustrating the trends in the use of MPS procedures in countries with a universal healthcare system.