Context is everything, especially when it involves the healthcare industry, the complexity of which has been well-documented. The rising cost of healthcare has been debated, discussed and dissected for decades. However, a study released in the Journal of the American Medical Association (JAMA) this last June, created quite a stir when suggesting that medical imaging was on the rise. This, of course, attracted a response from the medical imaging community.
First, let’s put this in perspective and look at some comparisons to understand how this conclusion could have been reached and where it may be flawed.
Medical Spending: U.S. versus Other Industrialized Countries
The fact that the U.S. spends more on healthcare than other industrialized countries comes as no surprise. A new report, “Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality,” does, however, shed some light on why the U.S. uses medical imaging at higher rates relative to other countries.
“Higher prices, more readily accessible technology, and increasing obesity of the U.S. population appear to be the main factors driving the high rates of U.S. spending, rather than greater use of hospital and physician services,” writes the report’s author, David Squires, senior research associate of international health policy at the Commonwealth Fund. (Source: AuntMinnie.com)
Squires wrote that the high cost of healthcare in the U.S. does not seem to be explained by a greater supply or utilization of healthcare services. For example, the U.S. had the fewest physician consultations, at 3.9 per capita, of any country except Sweden, as well as low levels of hospital utilization. This statement would seem to vindicate radiologists and medical imaging departments. But, there’s more.
Comparing Medical Imaging Statistics
When looking at utilization over time and comparing medical imaging statistics of the 2000s to the 1990s, Medicare data has shown that imaging use is actually down since 2008, according to American College of Radiology (ACR), Medical Imaging & Technology Alliance and the Access to Medical Imaging Coalition (to refute yet another study.) Medicare spending on scans is at the same level it was in 2003, the ACR noted.
While it’s true that CTs and MRIs had been on the rise over the past two decades, “often missing is the fact that the imaging exams eliminate the need for riskier and more costly invasive procedures,” said William T. Thorwarth, Jr., MD, RSNA board of directors liaison for publications and communications and radiologist at Catawba Radiological Associates in Hickory, N.C. (Source: HealthImaging)
Go to CommonwealthFund.org for the full report. Opens in a PDF.