During the past several years, the availability of computed tomography
(CT) and magnetic resonance imaging (MRI) scanning has grown rapidly.
Since the use of imaging technologies has associated costs and
benefits, the question arises whether their benefits outnumber the
costs or not? Which in turn would show whether their widespread and
growing use by the medical industry
The question being multifaceted, doesn't lead to simple
answers, however a study by Stanford University researchers recently
published in an issue of the journal Health Affairs
attempts to solve the puzzle. The research correlated Medicare claims
data with U.S. censuses that recorded the number and location of MRI
and CT units at four points in time.
Increasing MRI and CT facilities and their Use
The researchers' data mining efforts uncovered that the estimated
number of CT units grew more than 50 percent between 1995 and 2004,
while the estimated number of MRI units more than doubled.
- In addition, there was clear relationship between the availability of
imaging units and their use. For example, they found that each
additional MRI unit led to 733 more MRI procedures per year among
Medicare clients aged 65 and more.
The Costs and Benefits of Imaging Technology Use
- Similarly, an additional CT unit led to 2224 more procedures conducted annually.
Each additional MRI unit associated with 733 more MRI procedures per
year among Medicare beneficiaries age 65 and older, adds US$550,000 to
annual Medicare costs. On similar lines, each additional CT unit
associated with 2224 more procedures per year, leads to a figure of
US$685,000 in Medicare costs.
Further, at an individual level, the costs associated with increasing
imaging tests not only include the costs associated with the procedures
performed with this equipment, but also
include the costs incurred as a consequence of imaging, in the form of
subsequent healthcare such as follow-up tests, etc.
At the same time, imaging can lead to an earlier diagnosis of a
treatable abnormal medical condition and as a result improved outcomes.
Even if the tests don't uncover a problem, they can still provide
valuable information to guide medics in ruling out suspected
abnormalities and advise further tests, prescription drugs
While it might be a relief for patients to see their own tests turn out
negative results, studies have found that sending patients for
additional testing can produce anxiety that persists even when the
tests eventually show up as "negative."
On another front, considering imaging in comparison to older generation
and procedures e.g CT angiography (an imaging procedure) and a
catheter-based angiography (an older invasive procedure which carries
the risk of complications, including potentially life-threatening
embolisms), imaging may offer higher sensitivity, specificity, accuracy and less risk.
A related benefit is that imaging may lead to quicker and more precise
diagnoses, helping initiate appropriate treatment quickly and hence
lead to better outcomes.
On the whole the benefits of expanded imaging have some measurable
health outcomes in addition to some less tangible of benefits. However,
there still remain challenges for researchers about how to measure and
analyze these benefits. In addition there's also the puzzle of the
extent to which the healthcare system should pay for the less tangible
benefits, which may lend themselves to be measured easily and