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Les tests médicaux de formation image conduisent vers le haut des coûts de santé

par Lynn Shapiro, Writer | November 19, 2008

From 1997 through 2006, use of almost every type of imaging technology increased, including CT scans, MRI, ultrasound, nuclear medicine, x-rays, and arteriography. Annual imaging costs more than doubled from $229 per enrollee in 1997 to $463 per enrollee in 2006. In looking at specific technologies, researchers show that
-- Use of CT, MRI, and ultrasound combined rose significantly from 260 to 478 examinations per thousand enrollees per year
-- CT imaging more than doubled from 81 to 181 exams
-- MRI imaging more than tripled from 22 to 72 exams during the study period.

Cross-sectional imaging studies, which include CT, MRI, and ultrasound, added to existing tests using older technologies instead of replacing them. This pattern is common with the development of new technologies, the authors write. The study looked at how patterns in medical imaging varied by a patient's age, sex, image type, and the technology used. Increased imaging use among every group studied makes it clear that no single group, regardless of age, sex, or disease, can be the single focus of efforts to reduce imaging, the researchers write.

Although it would be ideal to curtail medical imaging by decreasing the use of costly and inappropriate or ineffective imaging, the researchers say that it remains "difficult to identify which imaging tests are most beneficial, and strategies that rely on financial disincentives tend to decrease imaging across the board, instead of selectively reducing unnecessary imaging." More focus should be on studying the cost-effectiveness of these tests and the effect on patient care so that policymakers, payers, and providers can better figure out how best to apply imaging technology, they add.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org. The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it will switch to pay-per-view for nonsubscribers. Web Exclusives are supported in part by a grant from the Commonwealth Fund.

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