7. CT and MRI referral practices under mandatory social health insurance

Аңдатпа

Background. Modern imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), are vital for diagnosing and monitoring diseases. Despite their value, challenges include high costs, radiation risks, and limited accessibility. Effective use requires collaboration between general practitioners (GPs) and radiologists. Misguided referrals burden healthcare systems, while underuse delays diagnoses. Objective. This study assesses GPs’ awareness of CT/MRI indications, examines challenges in referrals under the mandatory social health insurance framework, and analyzes radiologists’ views on unjustified referrals.

Methods. Two surveys were conducted: one among 108 radiologists in Almaty and Astana and another among 163 GPs in Almaty and the Almaty region. Questionnaires included closed and open-ended questions, and responses were analyzed to identify barriers and optimize diagnostic processes.

Results. Among radiologists, 56.5% reported more than five unjustified referrals per month, with CT being the most overused modality (80.6%). Reasons included GPs’ lack of knowledge about indications (66.7%) and patient pressure (67.6%). GPs cited limited mandatory social health insurance framework quotas (29.3%) and long waiting times (19.9%) as significant barriers. Both groups emphasized the need for clear clinical guidelines, enhanced education, and better interprofessional communication.

Conclusion: Systemic improvements in radiology services are necessary. Key recommendations include developing national clinical guidelines, educating GPs on CT/ MRI indications, and streamlining administrative processes. These measures will reduce unjustified imaging, improve resource use, and enhance patient care.