Utilization patterns of CT and MRI in Israel

Background: One of the major factors contributing to the escalating increase in the costs of the health system is the accelerated utilization of health technologies such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Prior to this study in Israel, there was no available national database to ascertain the scope and utilization patterns of imaging technologies. A number of trends combine in the need to assess the utilization patterns in Israel. Firstly, imaging examinations constitute a larger and ever-growing predominate role in the diagnostic process. Secondly, these technologies can complement or supplement each other. Thirdly, the rising costs to the health system resulting from the numerous examinations conducted and finally, the importance of protecting public health from the damage caused by exposure to radiation during CT examinations. Objectives: 1. To describe the utilization patterns for CT and MRI examinations in Israel. 2. To compare the consumption of imaging services with that of other Western countries. Methods: The initial stage was to identify all the institutions operating CT or MRI devices. Data was collected by means of a questionnaire from these organizations on the extent of use, characteristics of the utilization patterns, indications, accessibility, availability, and referents etc. during the period 1995-1999. Results: In the year 2000, 38 CT and 9 MRI devices were operating in Israel. We observed an increase in the number of CT and MRI examinations between the years 1995-1999 and a rise in the level of examinations per 1,000 population. The rate of MRI examinations per person in Israel was found to be lower in comparison to other Western countries. Upon analysis of the distribution of indications it was found that approximately 37% of the CT examinations were cranial examinations and 18% were spinal examinations. In MRI examinations 38% were cranial and 30% spinal tests. Conclusion: The rising trends in the rate of CT and MRI examinations during the period 1995-1999 and their characteristics, match the comparable rise witnessed in most Western countries in recent years. Although the level of CT and MRI devices per population in Israel is low in comparison to the Western world, the devices operate intensively. In light of the high level of accessibility and availability of these imaging devices in Israel, the research findings corroborate the claim that the number of devices influences the scope of utilization and supports the supposition that these imaging devices are used efficiently in Israel.