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Imaging may not be major driver of
hospital cost increases
MGH study shows increased utilization,
same percentage of overall costs
BOSTON - May 24, 2005 - The substantial increase in the use
of medical imaging during recent years has fueled speculation that
imaging costs were a major factor behind the rise in overall health
care costs. However, a study from the Institute
for Technology Assessment at Massachusetts General Hospital
(MGH) has found that imaging costs remained at a steady percentage
of overall hospital costs during a six-year period. The report will
appear in the June issue of Radiology and has been released
on the journal's website.
"There have been several news stories and reports from insurers
claiming that imaging costs are catching and even surpassing drug
costs as major drivers of health care inflation," says Scott
Gazelle, MD, MPH, PhD, an MGH radiologist who is director of the
Institute for Technology Assessment and co-author of the Radiology
article. "Those of us who work in imaging believe that its
use should be celebrated, since imaging has truly transformed the
way we deliver health care. But we also need to understand the value
that imaging brings to health care; and when looking at its costs,
we need to make sure our analyses are accurate."
In order to objectively assess imaging's contribution to hospital
costs, Gazelle and his co-author Molly Beinfeld, MPH, analyzed billing
records for patients admitted to MGH between 1996 and 2002. They
reviewed data on more than 17,000 patients with diagnoses in six
areas typically utilizing imaging - stroke, appendicitis, lung cancer,
upper gastrointestinal disorders, colon cancer and back pain - and
compiled information regarding specific imaging studies that were
carried out and their costs.
During the study period, the total number of CT scans and MRI studies
more than doubled, reflecting increases in the number of patients
in the groups analyzed, how many had imaging studies and the number
of studies ordered per patient. However, the contribution of imaging
to the overall cost of care for these patients remained steady at
about 10 percent.
"We actually expected that imaging would represent a higher
percentage of costs, but this result makes it hard to say that imaging
is driving increased overall costs," says Gazelle. "A
particularly surprising finding suggests that patients with higher
imaging costs might have a shorter length of stay, but that observation
needs to be confirmed in further studies."
He adds that future research should look at the impact of imaging
costs across a broader range of institutions and settings and throughout
patients' entire course of care, not just during hospitalization.
Gazelle is an associate professor of Radiology at Harvard Medical
School.
Massachusetts General Hospital, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $450 million
and major research centers in AIDS, cardiovascular research, cancer,
cutaneous biology, medical imaging, neurodegenerative disorders,
transplantation biology and photomedicine. In 1994, MGH and Brigham
and Women's Hospital joined to form Partners HealthCare System,
an integrated health care delivery system comprising the two academic
medical centers, specialty and community hospitals, a network of
physician groups, and nonacute and home health services.
Media Contact: Sue
McGreevey, MGH Public Affairs
Physician Referral Service: 1-800-388-4644
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