Study confirms recent decline in imaging utilization

A study of emergency department imaging utilization shows that while utilization substantially increased in the period between 1993 and 2007, it fell over the next five years, mostly as a result of the declining use of MRI and CT.

The study, published in the August issue of the American Journal of Roentgenology, examined utilization trends in the ED at Brigham and Women's Hospital in Boston from Jan. 1, 1993, through Dec. 31, 2012.

According to the researchers, led by Ali S. Raja, M.D., of the Center for Evidence-Based Imaging at Brigham and Women's, the total number of relative value units (RVU) attributable to ED imaging per 1,000 visits to the ED increased by 208 percent from 1993 to 2007, and then decreased by 24 percent by 2012.

CT RVUs increased 493 percent through 2007, while MRI RVUs increased 2,495 percent during that time. After 2007, however, RVUs for those two modalities decreased by 33.4 percent and 20.6 percent, respectively.

This is the latest study confirming that imaging utilization increased up until the Deficit Reduction Act was passed.

For instance, research published last November showed that while advanced imaging utilization peaked during the first part of the 21st Century, it slowed dramatically in the latter part of the first decade. According to that study, MRI/CT utilization rates increased from 64.3 to 119.6 per 1,000 persons in the period from 2000 to 2008, and then declined to 109.1 per 1,000 persons in 2009. Furthermore, while MRI/CT utilization rates increased at a rate of just under 15 percent from 2000 to 2005, those rates fell to an average annual growth rate of almost 0 percent from 2005 to 2009.

Meanwhile, research published in the Journal of the American College of Radiology in September 2012 found Medicare spending on non-invasive diagnostic imaging tests to be down 21 percent after peaking in 2006.

To learn more:
-see the study in the American Journal of Roentgenology