Little has been published characterizing specific patterns of the dramatic rise in diagnostic imaging during the past decade. In a large health plan, 377,048 patients underwent 4.9 million diagnostic tests from 1997 through 2006. Cross-sectional imaging nearly doubled over those years, rising from 260 to 478 examinations per thousand enrollees per year. Imaging with computed tomography (CT) doubled, and imaging with magnetic resonance imaging (MRI) tripled. Cross-sectional studies added to existing studies instead of replacing them, and the annual per enrollee cost of radiology imaging more than doubled. The dramatic rise in imaging raises both costs and radiation exposure. The use of diagnostic imaging has increased dramatically over the past decade, contributing to medical costs and to medical exposure to ionizing radiation. 1 The recent overview from the Medicare Payment Advisory Commission (MedPAC) to the Centers for Medicare and Medicaid Services (CMS) reported that the rise in volume of imaging services per Medicare beneficiary outstripped the growth of all other services physicians provide. 2 Several factors have contributed to this increase, including wider availability of technology, increased demand by patients and physicians, favorable reimbursement, and improvements in the technology resulting in a lower threshold for using it. Several studies have documented the increase in imaging over time, but relatively little has been published characterizing patterns of imaging in detail-specifically, how imaging patterns vary by patient factors, imaging modality, or the anatomic area being imaged. 3 This type of analysis would allow those interested in cost containment to understand where most imaging-and most expense-occurs. Further, it is largely unknown whether newer and more expensive imaging tests are replacing or being used in addition to older tests, such as x-rays.
Besides, during the past several years there has been an important increase in the use of diagnostic medical imaging REF .
Rising Use Of Diagnostic Medical Imaging In A Large Integrated Health System
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