Rise in Rate of Diagnostic Imaging

A team of researchers conducted the study using data from 377,000 patients enrolled in the Group Health Cooperative in Washington State between 1997 and 2006. The study population underwent five million radiology tests during this ten-year period.

Analysis showed an increase in all type of imaging technologies, with the majority of the tests being X-ray procedures. The average total imaging cost per patient, per year doubled during the study period, from 229 US-Dollars to 443 US-Dollars.

The most striking finding was the increase in the number of newer and pricier tests such as computed tomography and magnetic resonance imaging scans, according to the researchers. In 1997, 13.5 percent of the study group had undergone a CT, MRI, or both, and in 2006 it was 21 percent. Study results showed the per-patient number of CT scans doubled over the ten years, and the number of MRI scans tripled. This increase in CT and MRI imaging appeared across the board, with no single patient group or disease group dominating, according to lead author Rebecca Smith-Bindman.

The goal with newer imaging tests is to use them in the most efficient and effective way possible and as a replacement for older, less accurate tests, emphasised Smith-Bindman. "But we found the newer tests, such as CT and MRI, are being added on top of the old tests, such as X-rays, rather than replacing them - and this increases costs.”

"Using these tests wisely can detect treatable diseases and save lives. Excess imaging may be too much of a good thing. In addition to health care costs, we need to consider patients' exposure to potentially cancer-causing radiation. The benefit of testing needs to be balanced against the risk," she said.

The study findings also highlight concern about a correlation between the type of health care practice and rates of imaging, Smith-Bindman said. "Unlike managed care systems such as Group Health that receive a fixed amount to care for each patient, 'fee-for-service' practices get financial rewards for doing extra testing, including recouping investments in office-based scanning equipment. It is likely that rates of testing are higher in fee-for-service practice, and this habit of doing more imaging may be spreading into managed care."

COMPAMED.de; Source: University of California - San Francisco