The use of diagnostic imaging tests is rising rapidly and contributing to the increasing cost of healthcare, concludes a new study by researchers at the University of California, San Francisco and the Group Health Center for Health Studies in Seattle.
The study, co-authored by Diana L. Miglioretti, associate investigator, and Eric B. Larson, MD, executive director, of the Group Health Center for Health Studies, is being reported in the November/December issue of the journal (italics) Health Affairs (end italics).
Researchers used data from 377,000 patients enrolled in the Group Health Cooperative in Washington state between 1997 and 2006.
An 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 almost doubled during the study period, from $229 to $443. The population studied underwent 5 million radiology tests over the 10 years.
The researchers noted an increase in the number of newer and more expensive tests, such as computed tomography and magnetic resonance imaging scans.
In 1997, 13.5 percent of the study group had undergone a CT scan, MRI, or both. In 2006 the number rose to 21 percent. Study results showed the per-patient number of CT scans doubled over the 10 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, MD, an associate professor of radiology and biomedical imaging, epidemiology and biostatistics and obstetrics, gynecology and reproductive sciences at UCSF.
"We found the newer tests, such as CT and MRI, are being added on top of the old tests, such as X-rays, rather then replacing them - and this increases costs," she said. "Like first-time parents taking baby pictures, we may be overdoing it with newer diagnostic imaging tests. Using these tests wisely can detect treatable diseases and save lives. Excess imaging may be too much of a good thing. In addition to healthcare costs, we need to consider patients' exposure to potentially cancer-causing radiation. The benefit of testing needs to be balanced against the risk."
The study focused on managed care patients. Smith-Bindman suggested the increase in diagnostic imaging might be even higher in fee-for-service practices that receive financial rewards for doing extra testing.
Do the results of the study surprise you? Send your comments to Bernie Monegain at bernie.monegain@medtechpublishing.com