Current status, utilization, and geographic distribution of MRI devices in Jordan

Abstract

Despite increased scrutiny by health-care organizations regarding the utility, accessibility, and costs associated with imaging, magnetic resonance imaging (MRI) is one of the most powerful diagnostic tools in contemporary clinical medicine and has become critical to many clinical specialties to improve patient care. However, the geographical distribution of these machines, as well as their application in resource-scarce countries such as Jordan, has not been thoroughly researched. Therefore, the purpose of this research is to determine the current situation, geographical distribution, and utilization of MRI services in Jordan. This cross-sectional study was conducted from December 15, 2020 to January 15, 2021, at 167 health facilities in Jordan. Surveys were used to gather information on the current and equity status of MRI numbers, device characteristics, and utilization rate. To measure MRI units per million inhabitants among Jordanian governorates, descriptive analysis was conducted at multiple levels, including in OECD countries, regionally, and nationally. The Lorenz curve and the Gini coefficient, both indices of inequalities in the distribution, were used to determine the distribution of MRI units. By 2020, 373,824 MRI scans had been performed in Jordan on 85 existing MRI units. In 2020, Jordan had less MRI scanners per million population than most of the OECD countries, varying from 14.4 in the governorate of Aqaba to zero in the governorate of Madaba. In all Jordanian governorates, the equity of the MRI distribution remained low and was strongly negatively associated with population density. The Gini coefficient for MRI was 0.30. In Jordan, there is a relatively low inequality in MRI allocation in terms of geographic distribution. Across all Jordanian governorates, MRI distributions were significantly inversely related to population density. The rate of MRI unit utilization varied by governorate. The majority of MRI units were concentrated in Amman, Jordan’s capital, where population density is higher and profit opportunity is greater. However, MRI was utilized more frequently in military and university hospitals. In 2020, the number of MRI scanners per million population was lower than in the majority of the OECD countries. Infrastructure and population density are important factors to consider in future planning to ensure equitable distribution of high-tech medical equipment.