With MRI waiting times as long as a month for urgent cases, Canadian health authorities have failed to apply simple strategies to schedule patients for the country's 122 publicly funded MRI centers.
That finding from a survey of Canadian MRI practices suggests that facility managers have been less than vigilant about enforcing guidelines for making the best use of scarce MRI resources supported by the country's single-payer healthcare system.
Most of the 80 facilities responding to the survey had rules in place to decide who deserved priority attention. But fewer than half documented whether they were enforced, reported senior investigator Dr. Derek Emery, an associate professor of radiology at the University of Alberta. The findings were published in Healthcare Policy (Politiques de Santé 2009;4[3]:76-86).
Procedures are so inconsistent across the board that patients who urgently need a scan might get it within 24 hours at one clinic and within a month at another, according to reports by the Canadian Press, a multimedia news service. For lower priority scans, patients faced waiting lists that ranged from 28 days to three years.
The Canadian Association of Radiologists has developed imaging appropriateness guidelines, but their influence on medical practice is not well understood.
“We do not currently know the extent of inappropriate overuse of MRI, nor do we know the extent of inappropriate underuse,” Emery said.
The Canadian Institute for Health Ministry reported that 222 MR scanners operated in Canada in January 2007, up from 149 scanners in 2003.With six MR scanners per million people, the country ranked below the Organization for Economic Cooperation and Development median of seven MRI systems per million in 2005.
