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Policy development for CT and MRI services in Manitoba
1Department of Radiology, University of Manitoba, Winnipeg, Canada.
Insights
Canadian healthcare is evolving. A review found 33,552 computed tomography (CT) scans are reasonable for 1.1 million people, recommending resource allocation based on clinical need.
Area of Science:
- Health economics
- Medical imaging utilization
- Canadian healthcare policy
Background:
- Economic shifts impact Canadian medicine.
- Manitoba has 4 hospitals with CT services; 8 planned expansion.
- Ministry of Health requested a review of CT services.
Purpose of the Study:
- To assess the clinical need for computed tomography (CT) services in Manitoba.
- To evaluate the cost-effectiveness and resource allocation for CT scanners.
- To provide recommendations for future CT service expansion.
Main Methods:
- Analysis of 13,996,240 physician claims and 149,480 hospital discharges across 287 disease categories.
- Reviewed clinical activity data to determine reasonable CT examination numbers.
- Formal review process involving 12 hospitals and 7 experts.
Main Results:
- 33,552 CT examinations are deemed reasonable for a population of 1.1 million.
- Annual operating cost per CT scanner is estimated at one million dollars.
- Magnetic Resonance Imaging (MRI) is expected to reduce CT use for neurological conditions.
Conclusions:
- Further resource allocation for CT services should be contingent on proven clinical need.
- Reactivation of a strong management committee is recommended.
- Anticipated growth in MRI for nervous system diseases may impact future CT demand.
Abstract:
Economic forces are changing Canadian medicine. There are four hospitals in Manitoba with CT services and eight were planning to add services based on public subscription, internal transfer of resources and expected growth. The Ministry of Health requested an in depth report and review. Analysis of clinical activity for 287 disease categories from 13,996,240 physician claims and 149,480 hospital discharges reveal that 33,552 CT examinations are reasonable for 1.1 million people. The cost of operating each scanner is one million dollars per year. A formal review process of the report by the 12 hospitals and 7 selected experts was conducted. An advisory committee of all interested parties recommended that no further resources be allocated without proven clinical need and that a strong management committee be reactivated. MRI growth for nervous disease is expected to replace much CT activity in the next five years.