Swiss Hospital Institute's approach to the problems of magnetic resonance imaging

The Swiss Hospital Institute, a nonprofit institution that provides guidance on hospital planning and operation to Switzerland's health care community, conducted in 1984 a comprehensive study of magnetic resonance imaging (MRI) and magnetic resonance spectroscopy via a 17-member commission that examined all aspects of these emerging technologies. Future MRI utilization was estimated by developing five clinical categories of possible MRI use, based on ICD codes, and a probability of MRI utilization was developed for each category. By applying these probabilities to the number of inpatient admissions in each category, an annual nationwide volume of 20,000 scans was estimated. Ten MRI systems were considered adequate for a period of up to five years after the report's promulgation, based on a per-system annual throughput of 1,900-2,000 patients. A superconducting-magnet system with an 0.5-T field strength was deemed the most suitable, with units to be located in university hospitals. [Spectroscopy was considered best left to separate research installations.] The cost of equipment and construction for the 0.5-T superconducting magnet system were calculated as high as 3.6 million Swiss francs (Sfr) (approximately $1.65 million at fall 1985 exchange rates). the annual operating cost was estimated as Sfr 1.3 million ($600,000). On this basis a per-study fee of Sfr 690 ($315) was projected. The study recommended health insurance coverage of MRi use, only in patients with well-proven clinical indications for an MRI scan. The report is expected to aid in the orderly introduction of MRI into Switzerland's health care system.