Analysis of Factors Influencing Regulatory Compliance to Contain Man-made Ionizing Radiation from Medical Diagnostic Imaging Equipments in Corporate Hospitals, Tamil Nadu, India

Aims: To evaluate the current status of practices being followed to comply with regulatory guidelines by corporate hospitals for containing man-made ionizing radiation while using medical diagnostic imaging equipments. To statistically test and conclude whether Corporate Hospitals located in Metro and Non-metro cities, Revenue and Patient Queue Size influences the compliance.

Study Design: Descriptive Research design has been adopted in this study.

Place and Duration of Study: This study has been conducted in Tamil Nadu, India covering 25 metro and non-metro cities, for the period between June 2015 and May 2016.

Methodology: This research has scoped in 77 corporate hospitals who have expressed willingness to participate in this study out of 214 institutions approached. This study is based on the Regulatory guidelines published by Atomic Energy Regulatory Body, the Regulatory Body in India which controls the distribution and usage of Diagnostic Imaging equipments. This study has designed 7 dependent parameters (Regulatory, Layout Engineering, Technician Competency, Human Safety, Operations Know-How, Radiation Exposure Monitoring and Top Management Commitment). A structured questionnaire with 70 questions on a seven point scale (inclusive of zero) was constructed and administered for data collection. The parametric statistics has been adopted for statistical analysis of data.

Results: The mean of seven dependent variables have been found to be at the higher side of the measurement scale (Regulatory 5.64, Layout Engineering 5.62, Technician Competency 5.59, Human Safety 5.61, Operations Know-How 5.62, Radiation Exposure Monitoring 5.65 and Top Management Commitment 5.67). The corporate hospitals in Metro cities are found to exhibit significantly higher compliance when compared to non-metro, as confirmed by ANOVA results with ‘F” ratio of 16.51, “P” value 0.00157 at a confidence interval of 99.5 percent and alpha value 0.005. Pearson’s correlation coefficient ‘rho’ was found to be 0.057, with a “P” value (0.365) greater than alpha (0.05) at 99.5 percent confidence interval established weak and insignificant relationship between revenue and compliance index. Similarly, the patient queue size did not influence compliance index as revealed by correlation coefficient of 0.104, “P” value 0.312, alpha value 0.05 at 99.5 percent confidence interval.

Conclusion: It was quite evident from this research study that corporate hospitals have established very higher level of regulatory compliance with complete support and involvement of the Top Management. The top 5 key drivers that have led to such a superior level of regulatory compliance have been identified as Appoint full time Radiation Safety Officer, AERB Type approvals & renewals, Usage of TLD badge and testing dosage levels, Monitoring AERB approval policy and Engaging Service providers for equipment Servicing. This research study further recommends similar research work in other states of India and the requirement of a concrete mathematical model for estimation of Radiation Compliance Index.