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Medical imaging

Canadian healthcare riddled with aging technology

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– Canadian patients are enduring greater risks because the country’s healthcare system regularly employs aging and outdated medical technology, concludes a new report from independent research organization the Fraser Institute.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unavoidable truth regarding the state of Canada’s medical technology inventory is that there are far too many old and outdated machines being used to diagnose and treat the ailments of Canadians.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 care.”

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 Equipment.

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 www.fraserinstitute.org.

 

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