Aging equipment infrastructure threatens Canadian diagnostic imaging
“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,” said Nadeem Esmail director of health system performance studies at the Fraser Institute.
The report compared 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 compared the sophistication of existing technologies to recommendations by Ontario’s Expert Panel on MRI and CT.
It found 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,” Esmail said. “Yet the Canadian healthcare system has two to three times that amount of equipment older than 10 years.”
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 cath labs were beyond their life expectancy at the start of 2007.
The report found that some medical technologies had been in service well over two decades; others even longer than that.
Esmail said that Canada’s failure to invest in new medical technology cannot be explained by a lack of money. On the contrary, he noted that Canada’s universal access health insurance program is among the developed world’s most expensive. In fact, the federal government transferred CAD$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,” he said. “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.
“It’s time to consider alternatives to the status quo if we want to achieve a world-class, universal access healthcare system,” Esmail offered. “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 organization’s peer-reviewed report on the aging imaging equipment, which determined 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.