por Lynn Shapiro
, Writer | November 19, 2008
Bethesda, MD -- A dramatic expansion in the number of magnetic resonance imaging (MRI) and computed tomography (CT) scans since 1995 has led to increased outlays for the federal government and other payers but not necessarily to better health care or reduced mortality, researchers report in a new study published in the November-December issue of the journal Health Affairs. Get details at: http://content.healthaffairs.org/cgi/content/abstract/27/6/1467
On the other hand, even in managed care settings where there are no particular financial incentives to use imaging, it's difficult to discern which images are worth having and which are not. This creates a real quandary for U.S. policymakers hoping to rein in overall health costs. More information will be needed to determine whether the benefits of these technologies are worth the additional costs.
Between 1995 and 2004, the number of CT and MRI units more than doubled. Using Medicare claims data, Stanford University's Laurence Baker and colleagues from Stanford and Harvard University found that the number of MRI procedures per 1,000 Medicare beneficiaries increased from 0.3 in 1985 to 50 in 1995. By 2003, that number reached 173. CT procedures more than doubled from 1995 to 2005, from 235 per 1,000 beneficiaries to 547.
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What's In The Issue? Baker's study is the lead article in the new Health Affairs issue, a thematic volume that looks at the very real benefits, and the equally real costs, of the increasing use of such forms of medical technology as imaging and devices. The issue is supported by grants from the Blue Shield of California Foundation, Medtronic, and Johnson & Johnson. Get more at:
In addition to several articles examining the boom in medical imaging, (http://content.healthaffairs.org/cgi/content/abstract/27/6/1466), the issue contains articles addressing a variety of questions:
-- What are the costs and benefits of purchasing contract provisions that forbid device purchasers from disclosing the prices they negotiated with manufacturers? http://content.healthaffairs.org/cgi/content/abstract/27/6/1522
-- How should large health care payers like Medicare determine which new technologies to adopt and what levels of reimbursement to set? http://content.healthaffairs.org/cgi/content/abstract/27/6/1619
-- How much evidence of effectiveness should be required before new genomic tests or other interventions are allowed onto the marketplace? http://content.healthaffairs.org/cgi/content/abstract/27/6/1599