Healthcare policymakers working to rein in technology-related medical costs are challenged by a lack of dependable data about the benefits and drawbacks of expanding the use of advanced technologies, panelists said at a briefing held by the policy journal Health Affairs.
“The fundamental question is that of value,” said Laurence Baker, a health services research professor at Stanford University and a co-author on an imaging technology value study appearing in the November/December issue of Health Affairs. “Are we getting enough benefits to justify the increased use and costs that we see?”
In his study, Baker found that the number of CT and MRI imaging machines in use by private practices and hospitals more than doubled between 1995 and 2004, and the number of MRI procedures increased from 0.3 per 1,000 Medicare patients in 1985 to 173 per 1,000 in 2005. CT procedures grew from 235 per 1,000 in 1995 to 547 per 1,000 in 2005. But despite that, Baker said most of the attention has been on the cost of these cutting-edge technologies with few correlations being made among cost and tangible and intangible effects on patient outcomes.
“In the case of imaging, there is another big class of benefits—and that’s information,” Baker said. “Maybe a patient’s treatment options following an MRI result won’t be any different, but the information gained is valuable” for the patient and physician. He added that policymakers and lawmakers need well-rounded assessment of the direct and indirect benefits and drawbacks associated with advanced technology in order to create properly informed reimbursement guidelines and potential comparative-effectiveness rules. -- by Shawn Rhea