How do different countries perform in terms of number of medical imaging devices, scans, and specialized staff?
The talk “Imaging Challenges and Change: A Global Perspective”, presented at the Radiological Society of North America’s Annual Meeting (RSNA 2016), discussed the rapid changes and challenges that radiology faces in different countries. In fact, although medical imaging devices, like CT and MRI, are widely used worldwide, there are variations in the way and the extent they are adopted. Let’s have a look at the situation with MRI technology.
The two tables show the top 10 countries in terms of number of MRI devices and number of MRI examinations. You would imagine that these two values are strictly related. This is the case in the United States, Iceland, Switzerland, Austria, and Spain, where the number of MRI units and MRI exams go hand in hand. However, this pattern doesn’t always apply, and if you think more devices would results in higher usage, you’re wrong. Germany and Korea, respectively 3rd and 4th place in the race for MRI devices, performed less than half the MRI scans pro capita Estonia did (23.1 MRI exams/1’000 inhabitants in Germany, 27.3 MRI exams/1’000 inhabitants in Korea).
Further, neither the number of MRIs nor the number of scans accounts for the different price insurers pay for this diagnostic tool, as presented by the 2015 Comparative Price Report from the International Federation of Health Plans. In Spain, the average cost of an MRI exam from a private health plan is $130. The average raises to $503 in Switzerland, and $788 in the United Kingdom. In the U.S., the cost of an MRI scan usually spans between $448 (25th percentile) and $3’031 (95th percentile), with an average of $1’119, making it by far the most expensive country where to get a scan.
With almost one-third of Medicare spending for imaging in CT and MRI exams, over $1 billion were spent over MRI analyses. The high costs do not seem to stop the popularity of MRI as a routine diagnostic tool in the U.S. In fact, the number of scans doubled from 2000 to 2014.
This also results in an increased workload for radiologists. If we stick to the U.S., the number of MRI analyses shifted from 56/1’000 inhabitants to 110 MRI/1’000 inhabitants. Despite that, the number of radiologists increased of less than 2.5% in the same timeframe, for a total of 31’000 radiologists across the U.S. in 2014. The conclusion? A giant e-pile of increasing weight, which in 2014 contained approx. 1’131 MRI scans for each radiologist to sort. This means if an MRI exam is composed of an average of 570 images, each radiologist should go through 3.8 images/minute each single day, supposing they would all work full-time and solely on MRI.
In practice, radiologists have to go faster than that. If you think that’s a lot, wait to read the numbers for Turkish radiologists. With approx. 1/10 of the radiology population of the U.S., they had to go through over 10’200’000 MRI exams, resulting in over 3’400 scans per radiologist.
With high volumes of MRI machines, analyses, and spending, the U.S. always got on the MRI podium. Nonetheless, the case of Turkey clearly shows how the situation in the States doesn’t differ from the rest of the world. Different prices and numbers, but same trends and challenges everywhere, as the number of devices and analyses increases almost exponentially, but the number of specialists, which can interpret the results, doesn’t grow at the same pace.