Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 85<br />
In both regionalized and non-regionalized provinces, individual clinicians,<br />
particularly specialist physicians, play a major role in the decisions of RHAs<br />
and hospitals to purchase medical equipment, including the selection of a<br />
particular vendor. At the same time, provincial health ministries can play a<br />
key role in determining the timing and procurement of extremely expensive<br />
medical equipment, especially magnetic resonance imaging (MRI) units and<br />
computed tomography (CT) scanners. From the early to mid-1990s, provincial<br />
governments severely constrained their spending on advanced diagnostics.<br />
These actions created a bottleneck, lengthening waiting times <strong>for</strong> certain<br />
conditions and treatments (Romanow, 2002). Since that time, there has been a<br />
substantial investment in advanced diagnostics by provincial health ministries<br />
and delegated RHAs. As can be seen in Table 4.3, <strong>Canada</strong> now has a supply of<br />
CT, MRI and positron emission tomography (CIHI, 2012a) scanners roughly<br />
comparable to the supply in Australia (except <strong>for</strong> CT scanners), France and the<br />
United Kingdom.<br />
Table 4.3<br />
Number of selected diagnostic imaging technologies, per million population, in <strong>Canada</strong><br />
and selected countries, 2010<br />
CT MRI PET<br />
Australia 42.5 5.8 1.4<br />
<strong>Canada</strong> 14.4 8.4 1.2<br />
France 11.8 7.0 0.9<br />
United Kingdom 8.3 6.0 0.5<br />
United States 34.3 25.9 3.1<br />
Source: OECD (2011a).<br />
Notes: Data <strong>for</strong> Sweden were not available; CT: Computed tomography; MRI: Magnetic resonance imaging;<br />
PET: Positron emission tomography.<br />
Although <strong>Canada</strong> is still well below the supply of similar technologies in<br />
the United States, the simple counts of advanced technologies do not take<br />
into consideration the intensity of use, and there is evidence that advanced<br />
diagnostic technologies in <strong>Canada</strong>, particularly those that are hospital based,<br />
are more intensely used than the same imaging technologies in the United<br />
States. In fact, based on 2007 data, <strong>Canada</strong> ranked among the <strong>Europe</strong>an<br />
countries with the highest utilization efficiency of MRI scanners, with the<br />
number of examinations per MRI in unit second only to Belgium, and higher<br />
than France, Sweden and the United Kingdom (CIHI, 2008b).