Canadian healthcare riddled with aging
CALGARY – Canadian patients are
enduring greater risks because the country’s healthcare system regularly
employs aging and outdated medical technology, concludes a new report
from independent research organization the Fraser Institute.
“The unavoidable truth regarding the state of Canada’s medical
technology inventory is that there are far too many old and outdated
machines being used to diagnose and treat the ailments of Canadians.
This is a failure of the Canadian healthcare model,” said Nadeem Esmail,
Director of Health System Performance Studies at The Fraser Institute
and author of How Good is Canada’s Medical Technology Inventory?
“Older equipment has a higher risk of failing or breaking down, may be
less accurate or provide poorer quality images, can be less clinically
useful, and may be incapable of delivering the latest advancements in
The peer-reviewed report determines the age and sophistication of
medical technologies in Canada based on data from the Canadian Institute
for Health Information’s National Survey of Selected Medical Imaging
The report compares the age of existing Canadian medical technology in
both hospitals and free-standing facilities to guidelines established by
the European Coordination Committee of the Radiological and
Electromedical Industries (ECCREI) and the Canadian Association of
Radiologists, and compares the sophistication of existing technologies
to recommendations by Ontario’s Expert Panel on MRI and CT.
Esmail’s report finds that nearly 21 percent of hospital-based bone
densitometers, nearly 29 percent of hospital-based SPECT units, more
than 34 percent of hospital-based gamma cameras, nearly 32 percent of
hospital-based lithotriptors, more than 24 percent of hospital-based
angiography suites, and 28 percent of hospital-based cardiac
catheterization labs were more than 10 years old at the start of 2007.
“The ECCREI guidelines state that the installed inventory of these aging
units should not exceed 10 percent of the total inventory. Yet the
Canadian healthcare system has two to three times that amount of
equipment older than 10 years.”
Canada’s clinics generally seem to outperform Canada’s hospitals under
the ECCREI guidelines. Compared to hospitals, a smaller proportion of
the inventories of all types of medical technologies in clinics was more
than 10 years old.
Under guidelines established by the Canadian Association of
Radiologists, Esmail found that more than 48 percent of hospital-based
bone densitometers, nearly 12 percent of hospital-based CT scanners,
nearly 30 percent of hospital-based MRI machines, nearly 29 percent of
hospital-based SPECT scanners, more than 34 percent of hospital-based
gamma cameras, more than 42 percent of hospital-based lithotriptors,
nearly 46 percent of hospital-based angiography suites, and nearly 42
percent of hospital-based cardiac catheterization labs were beyond their
life expectancy at the start of 2007.
“Not only has much of the equipment exceeded its life expectancy, but in
some cases, a sizable additional proportion is nearing its lifecycle
guideline,” Esmail said.
As an example, he points to Canada’s hospital-based inventory of MRI
machines, where another 29 MRI machines (16 percent of the inventory)
had reached their six year lifecycle at the start of 2007. Similarly,
7.6 percent of cardiac catheterization labs had reached their life
expectancy at the beginning of 2007, as had 11.3 percent of
hospital-based bone densitometers.
Even more startling is the advanced age of some technologies still in
use in Canada’s hospitals. The report shows that some medical
technologies had been in service well over two decades; others even
longer than that.
For example, at the start of 2007, Canada’s oldest angiography suite was
45 years old. This compares to the ECCREI standard that machines over a
decade old are no longer state-of-the-art and should be replaced; and to
the lifecycle guidelines from the Canadian Association of Radiologists
that range from 6 to 10 years depending on the type of technology.
Esmail concludes that Canada’s failure to invest in the latest medical
technology cannot be explained by a lack of money. On the contrary,
Canada’s universal access health insurance program is among the
developed world’s most expensive such programs. He notes that the
federal government transferred $3 billion in targeted funding to the
provinces between 2000 and 2004 in an effort to improve the availability
of medical technology.
“Governments at all levels continue to promise increased spending on
healthcare in order to improve access to care in Canada. But the reality
is that Canadians’ lack of access to both medical care and up-to-date
medical technology is occurring in spite of Canada outstripping almost
every other developed nation in expenditures on its universal access
health insurance program,” Esmail said.
“It’s time to consider alternatives to the status quo if we want to
achieve a world-class, universal access healthcare system. Unless we
allow more competition into the both the financing and delivery of
healthcare services, Canadians will continue to be burdened with lengthy
waiting lists and outdated medical equipment.”
The Fraser Institute is an independent research and educational
organization with locations across North America and partnerships in
more than 70 countries. Its mission is to measure, study, and
communicate the impact of competitive markets and government
intervention on the welfare of individuals. To protect the Institute’s
independence, it does not accept grants from governments or contracts
for research. Visit