Medical Scans Used Most in Atlanta, Least in Seattle

Study finds wide variation in MRI, CT uptake depending on region

MONDAY, March 22, 2010 (HealthDay News) -- There's a big gap between regions in Medicare patients' use of diagnostic imaging such as CT scans, MRIs and PET scans, a new study finds.

"Underlying regional variation in imaging utilization raises concerns about cost and quality," lead author Laurence Parker, of Thomas Jefferson University Hospital in Philadelphia, said in a news release. "Wide geographic variation in utilization raises questions about underutilization and quality on the low side and overutilization and costs on the high side."

The researchers used 1998-2007 Medicare data to calculate regional rates of utilization and found that the Atlanta region had the highest rate -- 4.6 procedures per capita in 2007, 3.95 in 2002, and 3.47 in 1998. Seattle had the lowest rate -- 2.99 procedures per capita in 2007, 2.69 in 2002 and 2.33 in 1998.

"Per capita utilization in the highest region has been about 50 percent greater than in the lowest region over the course of the study, with this percentage increasing from 1998 to 2007," said Parker. "This is a substantial difference, greater than the increases within regions from 1998 to 2007. However, it's a much smaller difference than the eightfold variation in Medicare payments reported in previous studies, and we think a more accurate number.

"When we focus on high-technology, high-cost imaging categories, like CT, MRI and PET, many categories of imaging show more than 100 percent greater utilization. Many of the high variation categories are types of cardiovascular imaging," he added.

"There are many factors involved in regional variation in utilization, including morbidity and risk factors in the population, access-to-care factors, and general population factors," Parker said. "However, it seems very clear that there is substantial regional variation in imaging utilization, and it should be further explored."

Overall Medicare per-beneficiary growth in imaging uptake for 2006 and 2007 was 2 percent nationally -- at or below the growth rate of other physician services.

The study appears in the April issue of the American Journal of Roentgenology.

More information

The U.S. National Institutes of Health has more about diagnostic imaging.

Robert Preidt

Robert Preidt

Updated on March 22, 2010

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