Pattern and factors leading to the diffusion of magnetic resonance imaging in Korean hospitals

Objectives: The purpose of this study was to examine the diffusion patterns of new medical technologies in Korean hospitals. We also sought to identify critical factors leading to the decision to acquire capital-intensive medical technology. The rationale and timing of magnetic resonance imaging (MRI) acquisitions were retrospectively evaluated according to a "whether, when, and why" paradigm. Methods: We analyzed data pertaining to 232 hospitals with active medical residency programs. Of these, 185 hospitals owned or leased an MRI unit, and 47 had not acquired units as of June 2004. Data were collected from the Ministry of Health and Welfare, Korean National Statistical Office, and Korean Hospital Association databases, and variables were identified and classified as predisposing, enabling, or reinforcing factors. Results: The MRI diffusion rate curve was linear for two types of hospital but was S-shaped for tertiary hospitals, which were early adopters of MRI. Significant predictors for MRI adoption included the per capita number of regional physicians (+), total number of existing regional MRI units (-), percentage of the regional population over 65 years of age (+), private ownership of the hospital, presence of a radiology residency program, number of beds (+), and regional per capita taxable income (+). Conclusions: Diffusion of MRI technology is occurring rapidly across Korean hospitals. The factors affecting MRI adoption in Korea are similar to the factors documented in other countries, namely regional population over age 65, regional income per capita, large hospitals, and teaching hospitals. This study provides baseline information for predicting diffusion patterns of other new and/or expensive medical technologies.