Is declining medical imaging use driving up hospital stays and medical costs?

A new report by the Harvey L. Neiman Health Policy Institute shows that the length of the average hospital stay in the United States has increased at the same time as use of medical imaging scans has declined. It is unclear if the trends are related, but potentially important, as hospital admissions are among the largest, and fastest growing, health care costs. More research is needed to assess the potential negative impact of government and private insurer imaging reductions on overall medical costs and patient safety.

"Lawmakers, regulators and medical professionals are making medical imaging without fully understanding or examining their downstream effects—which may include an increase in hospital stays, associated costs and other adverse events. We need to examine imaging, as it relates to a patient's overall continuum of care, to ensure that decision makers don't create imaging cost reduction policies which paradoxically raise overall costs, create barriers to care, and ultimately harm patients," said Richard Duszak, MD, and senior research fellow of the Harvey L. Neiman Health Policy Institute.

Much of a building body of research regarding medical imaging focuses on declining costs and utilization of imaging. There is relatively little research focused on imaging as a component of overall patient care. For many serious indications, imaging scans have been shown to reduce the number of invasive surgeries, unnecessary hospital admissions and length of hospital stays. Rarer still is data on the effect of $6 billion in funding reductions for imaging diagnosis and treatment planning since 2006. The information that is available is not necessarily positive in terms of patient safety and access to care.

This is the first policy brief produced by the Neiman Institute, which conducts and supports research regarding medical imaging use, quality and safety metrics, and human resources as medicine moves toward non-traditional, value-based payment and delivery. The data gleaned from these efforts will serve as the basis for true, evidence-based medical imaging policy.

"We need to take a hard look at the cost, access and quality and safety issues related to present government and private insurer policies and find ways to maximize the value, role and efficiency of radiology as health care systems evolve. The Neiman Institute will provide much needed information to ensure that future imaging policies benefit patients and make efficient, effective use of resources," said Duszak.

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