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Original article

Vol. 142 No. 3940 (2012)

Exploring the use of the Swiss medical tariffication codes (TARMED) in the establishment of the frequency of radiodiagnostic examinations

  • Régis Le Coultre
  • Abbas Aroua
  • Eleni Theano Samara
  • Maxime Rochat
  • Stéphane Coendoz
  • Francis Robert Verdun
DOI
https://doi.org/10.4414/smw.2012.13677
Cite this as:
Swiss Med Wkly. 2012;142:w13677
Published
23.09.2012

Abstract

In population surveys of the exposure to medical X-rays both the frequency of examinations and the effective dose per examination are required. The use of the Swiss medical tariffication system (TARMED) for establishing the frequency of X-ray medical examinations was explored. The method was tested for radiography examinations performed in 2008 at the Lausanne University Hospital. The annual numbers of radiographies determined from the “TARMED” database are in good agreement with the figures extracted from the local RIS (Radiology Information System). The “TARMED” is a reliable and fast method for establishing the frequency of radiography examination, if we respect the context in which the “TARMED” code is used. In addition, this billing context provides most valuable information on the average number of radiographs per examination as well as the age and sex distributions. Radiographies represent the major part of X-ray examinations and are performed by about 4,000 practices and hospitals in Switzerland. Therefore this method has the potential to drastically simplify the organisation of nationwide surveys. There are still some difficulties to overcome if the method is to be used to assess the frequency of computed tomography or fluoroscopy examinations; procedures that deliver most of the radiation dose to the population. This is due to the poor specificity of “TARMED” codes concerning these modalities. However, the use of CT and fluoroscopy installations is easier to monitor using conventional survey methods since there are fewer centres. Ways to overcome the “TARMED” limitations for these two modalities are still being explored.

References

  1. United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR 2008 Report Vol 1: sources of ionizing radiation. New York: United Nations; 2010.
  2. European Commission. European guidance on estimating population doses from medical X-ray procedures. Brussels: Directorate General for Energy and Transport; Radiation Protection No. 154; 2008.
  3. European Commission. Review of recent national surveys of population exposure from medical X-rays in Europe. Annex to the European guidance on estimating population doses from medical X-ray procedures. Brussels: Directorate General for Energy and Transport; Radiation Protection No. 154; 2008.
  4. Aroua A, Burnand B, Decka I, Vader JP, Valley JF. Nationwide survey on radiation doses in diagnostic and interventional radiology in Switzerland in 1998. Health Phys. 2002;83(1):46–55.
  5. Aroua A, Decka I, Burnand B, Vader JP, Valley JF. Dosimetric aspects of a national survey of diagnostic and interventional radiology in Switzerland. Medical Phys. 2002;29(10):2247–59.
  6. Aroua A, Vader JP, Valley JF, Verdun FR. Exposure of the Swiss population by radiodiagnostics: 2003 review. Health Phys. 2007;92(5):442–8.
  7. Samara ET, Aroua A, Bochud FO, Ott B, Theiler T, Treier R, et al. Exposure of the Swiss population by medical X-rays: 2008 review. Health Phys. 2012;102(3):263–70.
  8. Aroua A, Valley JF, Vader JP. Radiation exposure by radio-diagnostics in Switzerland: a pilot patient-oriented purvey. Radiat Prot Dosim. 2004;109(3):211–5.
  9. Gron P. Private communication (2007).
  10. Brix G, Nekolla E, Griebel J. Strahlenexposition von Patienten durch diagnostische und interventionelle Röntgenanwendungen: Fakten, Bewertung und Trends. [Radiation exposure of patients from diagnostic and interventional X-ray procedures. Facts, assessment and trends]. Radiologe. 2005;45:340–9.
  11. Nekolla EA, Veit R, Griebel J, Brix G. Frequency and effective dose of diagnostic X-ray procedures in Germany, Proceedings of the jointly held Congresses ICMP 2005 and BMT 2005 (Editorial: W Kalender, EG Hahn, AM Schulte): Medical Physics. 2005;50(Suppl. 1–2):1334–5.
  12. Brugmans MJP, Buijs CAM, Geleijns J, Lembrechts. Population exposure to diagnostic use of ionizing radiation in the Netherlands. J Health Phys. 2002;82(4):500–9.
  13. Shannoun F, Zeeb H, Back C, Blettner M. Medical exposure of the population from diagnostic use of ionizing radiation in Luxembourg between 1994 and 2002. 2006;91:154–62.
  14. Olerud HM, Saxebøl G. Diagnostic radiology in Norway from 1983–1993- Examination frequency and collective effective dose to patients. Radiat Prot Dosim. 1997;74(4):247–60.
  15. Borretzen I, Lysdahl KB, Olerud HM. Diagnostic radiology in Norway: trends in examination frequency and collective effective dose. Radiat Prot Dosim. 2007;124(4):339–47.