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Infrastructure

Canada slow to adopt new medical technologies

CALGARY – Canada is slow to adopt the latest medical technologies, forcing Canadian patients to rely on old and often outdated medical equipment for treatment, says a new study from the Fraser Institute, an independent research organization.

“Lack of access to cutting-edge medical technology has significant consequences; the most obvious is that a patient’s survival or return to full health is compromised because of a later or less sophisticated diagnosis and more invasive treatment,” said Nadeem Esmail, Director of Health System Performance Studies at The Fraser Institute and co-author of Medical Technology in Canada.

“Equally disconcerting is that Canada’s total healthcare expenditures are among the highest in the developed world and yet the limited inventory of advanced medical equipment found in our healthcare system is often old and outdated.”

New medical technologies can provide faster and more efficient identification and treatment of disease. They can offer the patient safer, less invasive and more comfortable treatments and care, as well as offering new treatment options where none previously existed.

The peer-reviewed study, Medical Technology in Canada, evaluates the availability of medical technology in Canada compared to other nations within the Organization of Economic Cooperation and Development (OECD), measures the age and sophistication of medical technology in Canada, and measures the stock of available cutting-edge medical technology in Canada’s five largest cities: Toronto, Montreal, Vancouver, Ottawa, and Calgary.

This study focuses principally on technologies in the diagnostic imaging, laboratory diagnostic, surgical, and patient services areas.

The complete study is available as a free PDF download at www.fraserinstitute.org.

Using data from a number of international reports and research articles, the study finds that access to medical technology in Canada is well below average.

For example, according to the OECD, the number of MRI units in Canada (6.2 per million people in 2006) lags the OECD average (10.2 per million), and the number of CT scanners (12 per million people in 2006) also lags the OECD average (19.2 per million). Tellingly, the availability of both is about 60 percent of the level of the OECD average.

Another key indicator of Canada’s performance on the medical technology front is the availability of PET scanners (Positron Emission Tomography) which are used in cancer detection and treatment, as well as for Alzheimer’s disease, epilepsy, and in cardiology. The study finds that Canada ranks below average and ahead of only Finland, Spain, the United Kingdom, and the Netherlands among developed nations in the number of PET scanners per million people.

In total, the study finds that Canadians receive less access to advanced medical technologies than their counterparts in other developed nations, with Canada lagging behind a number of other nations in the rate of expansion in the inventory or application of technologies after their introduction.

When examining the age and sophistication of medical technologies used in Canada, the study finds that the Canadian heathcare system relies heavily on an inventory of older and outdated medical technologies. Canada also often relies more on less sophisticated forms of technology than is optimal.

For example, at the beginning of 2006, 14.8 percent of Canada’s hospital-based CT scanners, 29.3 percent of hospital-based MRI units, 26.1 percent of hospital-based SPECT units, 35.7 percent of hospital-based gamma cameras, 56.3 percent of hospital-based lithotriptors, 47.4 percent of hospital-based angiography suites, and 40.2 percent of hospital-based cardiac catheterization labs were older than their respective Canadian Association of Radiologists-developed lifecycle guidelines.

The study also surveyed the availability of 50 cutting-edge medical technologies at hospitals in Canada’s five largest cities and found that only 10 of these technologies were available in more than half the facilities that responded.

Of the remaining 40 technologies, 21 were present in 25 to 50 percent of the responding facilities, and 19 were present in less than one-quarter of responding facilities.

“The results of our failure to invest in new medical technologies are exemplified by long waiting times, less efficient use of medical resources, and less timely and sophisticated diagnosis and treatment,” Esmail said.

“Canada’s failure to invest in the latest medical technology cannot be explained by a lack of money. On the contrary, Canada’s universal access health insurance program is among the developed world’s most expensive such programs.”

Esmail points out that the federal government transferred $3 billion in targeted funding to the provinces between 2000 and 2004 in an effort to improve the availability of medical technology. Yet modern medical technologies still remain notably rare.

“Canadians desire access to modern and advanced medical technologies and they are already paying for that superior access. So why is spending on new medical technologies so constrained in Canada? Why are Canada’s relatively high levels of expenditures not purchasing the access to medical technology that one might expect?”

Esmail concludes that solving Canada’s medical technology dilemma can best be done by introducing more competition into the delivery of publicly funded services in Canada; using comprehensive, private insurance, both in parallel to and as a part of the universal system; and by strengthening the connection between the delivery of and payment for services.

The Fraser Institute is an independent research and educational organization with offices across Canada and the United States. Its mission is to measure, study, and communicate the impact of competitive markets and government intervention on the welfare of individuals. To protect the Institute’s independence, it does not accept grants from governments or contracts for research. Visit www.fraserinstitute.org.

 

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