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Australia, Austria, Belgium, Canada, Chile, Czech Republic, Denmark, Estonia, Finland, France, Germany , Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Korea, Luxembourg, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal, Slovak Republic, Slovenia, Spain, Switzerland, Sweden, Turkey, United Kingdom, United States,

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Diagnostic exams

Computed Tomography exams, total
Computed Tomography exams, in hospitals
Computed Tomography exams, in ambulatory care
Magnetic Resonance Imaging (MRI) exams, total
Magnetic Resonance Imaging (MRI) exams, in hospitals
Magnetic Resonance Imaging (MRI) exams, in ambulatory care

An exam is defined as a scan (a technical investigation using an imaging modality) to study one (or more than one) body part that yields one or more views for diagnostic purposes.

Definition of hospitals based on the SHA Manual (HP.1):
Establishments primarily engaged in providing medical, diagnostic, and treatment services that include physician, nursing, and other health services to in-patients and the specialised accommodation services required by in-patients. Hospitals may also provide out-patient services as a secondary activity.

Definition of ambulatory care providers based on SHA Manual (HP.3):
Establishments primarily engaged in providing health care services to patients who do not require in-patient services. This includes establishments specialised in the treatment of day cases. It also includes health practitioners in ambulatory health care, primarily providing services to patients visiting health professional's office.

Sources and Methods

Australia

Medicare Australia. Unpublished data from Location Specific Position Number register (2007-08) and unpublished Medicare data (2008-09).
* Medicare data provides the following split: "Item provided in Hospital" and "Item not provided in Hospital".
* Data pertain only to equipment registered for out-patient and private in-patient services. Exams in hospital exclude exams performed in public hospitals.

Austria

Statistics Austria, Hospital Discharge Statistics / Medical procedures (Spitalsentlassungsstatistik / Medizinische Leistungen).
* Data according to the “Catalogue of procedures” (Leistungskatalog) compiled by the Ministry of Health for the Austrian DRG-system (LKF).
* The Austrian catalogue of procedures is not primarily based on ICD-9-CM, but is widely compatible.
* Data is for all hospitals, including long term hospital care, rehabilitative care and convalescent care.
* Day cases are included.
* Data for ambulatory care are not available.
* Data for 1997-2005 will be available in the course of 2010.

Belgium

INAMI (Institut National d’Assurance Maladie-Invalidité): total number or reimbursed cases for CT-Scans (nomenclature codes: 458673,458684, 458710, 458732, 458743,458813, 458824, 458835, 458846, 458850, 458861, 458872, 458883, 458894, 458905).
INAMI (Institut National d’Assurance Maladie-Invalidité): total number or reimbursed cases for MRI-examinations (nomenclature codes: 459395, 459406, 459410, 459421, 459432, 459443, 459454, 459465, 459476, 459480, 459491, 459502, 459513, 459524, 459524, 459535, 459546).

Canada

Canadian Institute for Health Information, National Survey of Selected Medical Imaging Equipment (2004 to 2007).
* Exams are reported for the fiscal year beginning April 1 (before the survey year) and ending March 31 of the survey year. For example, in the 2007 National Survey of Selected Medical Imaging Equipment, exams were reported for the period April 1, 2006 to March 31, 2007. In OECD Health Data, the exams for this period are indicated as for 2006.
* Exam definition in the survey: A defined technical investigation using an imaging modality to study one body structure, system or anatomical area that yields one or more views for diagnostic and/or therapeutic purposes.

Chile

* Data not available.

Czech Republic

Institute of Health Information and Statistics of the Czech Republic. Survey on medical apparatus in health establishments.

Denmark

* National Board of Health The National Patient register.
* The data for CT- and MRI- exams are only available for public hospitals at this point in time.
* CT-scanners are available only in hospitals (public and private), and only 6 percent of all CT scanners are available at private hospitals, which mean that the figures for CT-exams cover almost all CT-exams.
* At this point in time we have no information on the distribution of MRI-Scanners between public and private hospitals, so we cannot say anything about how much the figures for MRI-exams are underestimated.
* Some scans performed in both public and private hospitals for outpatient cases, but we are not able to separate them out.

Estonia

National Institute for Health Development, Annual statistical report of health care providers.

Finland

* Data not available.

France

1) Exams performed in ambulatory care setting:
- CNAMTS, Evolution des actes techniques en secteur liberal en 2008. Points de repère n° 26, décembre 2009,
see http://www.ameli.fr/fileadmin/user_upload/documents/26_-_CCAM_2008.pdf.
- CNAMTS, Evolution des actes techniques en secteur liberal en 2007. Points de repère n° 21, décembre 2008,
see http://www.ameli.fr/l-assurance-maladie/statistiques-et-publications/points-de-repere/n-21-ccam-en-secteur-liberal-2007.php.
* Coverage: France (Metropolitan and D.O.M, i.e. overseas territory).
2) Exams performed in hospitals :
Data extracted from the SAE files (health institutions annual statistics) compiled by Drees (Direction de la recherche, des études, de l’évaluation et des statistiques) du Ministère de la Santé et des Sports.
* Institutions included irrespective of their status, categories, financing (e.g. private institutions belonging to public hospitals), or size. See http://www.sae-diffusion.sante.gouv.fr/Collecte_2008/.
* Coverage: France (Metropolitan and D.O.M, i.e. overseas territory).

Germany

Federal Statistical office, DRG-statistics (Diagnosis Related Groups, diagnoses and procedures of full-time patients in hospitals), Fachserie 12, Reihe 6.4
http://www.destatis.de or http://www.gbe-bund.de
* Included is the number of accomplished examinations with CT and MRI in hospitals (HP.1).
* DRG-statistics extend to all hospitals, which settle accounts according to the DRG-compensation system and which are subject to the scope of application of § 1KHEntgG. Beyond the field of application of the new pay programme there are primarily psychiatric and psychotherapeutic facilities.
* All significant operational interventions and medical procedures, which are made from the time of the admission of a patient up to the time of the discharge and which are presentable in the official code of operations and procedures (OPS) are to be coded by the hospitals. The definition of a significant procedure is that it is either of surgical nature, it involves an interventional or anaesthetic risk, it requires special facilities or special equipments or a special training.
* Additional data on the ambulatory sector is not counted in official statistics.
* Data before 2005 is not available.

Greece

Kazassis Biomedical Technology Consultant.
* Estimated figures have been provided for 2008. The figures represent number of exams both in hospitals and in outpatient units (diagnostic centers).

Hungary

Hungarian National Health Insurance Fund (OEP). See http://www.oep.hu.

Iceland

Statistics Iceland. Data collected from the institutions which have MRI and/or CT.
* The use of one MRI and one CT machines are research-dedicated so part of the total number of tests are for scientific purpose (2-3% of MRI exams and less than 1% of the CT exams in 2006-07).
Icelandic Radiation Protection Institute. 2008 data on diagnostic exams.

Ireland

Healthstat, Health Service Executive
* Data only covers approximately half of all public acute hospitals. However, hospitals not included would account for only a small number of additional cases.
* Private hospitals are not included.

Israel

* 2007-2008 data are based on administrative data from the Medical Technology Administration in the Ministry of Health. The data is collected periodically from the all MRI and CT units in hospitals and in the community. The data includes exams in all units. The exams in hospitals include exams for hospitalised patients (include exams in the emergency rooms); the exams in ambulatory care include exams in the community and out-patients services in hospitals for day cases and ambulatory cases.
* Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law.

Italy

* Data not available.

Japan

* Data not available on a yearly basis.
* Monthly data available from the Ministry of Health, Labour and Welfare, “Survey of Medical Institutions”. These data refer to the total number of patients who have received exams from 1st to 30th of September 2008 in a hospital or a medical clinic:
- Number of CT exams: 2246080.
- Number of MRI exams: 1075702.

Korea

Health Insurance Review & Assessment Service, unpublished data.

Luxembourg

Inspection générale de la sécurité sociale, fichiers (PEN 2) de la sécurité sociale.
* The rates presented in the database are calculated with the total population in Luxembourg as the denominator. Another option would be to use the insured resident population in Luxembourg as the denominator (428 457, 433 424, 439 628, 444 738, 449 972 and 455 752 persons from 2002 to 2007).

Mexico

* Data not available.

Netherlands

Statistics Netherlands, data from survey Beeldvormende Diagnostiek, as part of the data in the annual reports social accounting care.
* Number of MRI exams (rc81089+rc81090+rc81092+rc81290+rc82490+rc83190+rc83290+rc83390+rc84090+rc85090+rc87090+rc88090+rc89090).
* Number of CT exams (rc81342+rc82042+rc82445+rc83042+rc84042+rc85042+rc86042+rc87042+rc89042).

New Zealand

* The source for CT scans and MRI exams is the National Minimum Data Set (NMDS) and the data provided to OECD for these 2 diagnostic tests relates to publicly funded procedures for patients admitted to hospital including daycases. All procedures during the hospital stay that fall within the ICD procedure code selection criteria are counted e.g. CT scan + MRI in one hospital stay = 1 against both totals; 2 CT scans in one hospital stay=2 against CT total.
* The definition used includes all CT scans and MRIs reported regardless of what parts of the body are targeted.
* The codes used to identify these procedures are ICD-9-CMA-II codes. Data prior to July 1995 was coded using ICD-9-CM originally and mapped forward to ICD-9-CMA-II. However, there are no specific ICD-9-CM codes that identify MRIs so these procedures could not be coded.
* Note that the CT and MRI procedures reported via the NMDS do not count private sector procedures or those carried out in an ambulatory setting. The extent of the ‘under-report’ can be estimated for CT exams using a figure reported in a 2007 NRL survey (NRL Survey Computed tomography in diagnostic radiology: a survey of use and patient doses for New Zealand, 2007. G Stirling, A Cotterill. National Radiation Laboratory, 2009; http://www.nrl.moh.govt.nz/publications/nrlreports.asp) of computed tomography in diagnostic radiology (excluding CTs in use in nuclear medicine and radiotherapy). This reported that there were an estimated 98300 CT scans excluding extremity procedures in NZ facilities: this figure is 29% higher than the Ministry reported figure for that year using NMDS data.

Norway

* Data not available.

Poland

* Data not available.

Portugal

* Data not available.

Slovak Republic

National Health Information Center (NHIC). Annual Statistical Report K (MZSR) 4-01.

Slovenia

National Institute of Public Health. Hospital data: e-DRG data set.
*e-DRG statistics extends to all hospitals, which reports data through e-DRG application from April 2004 (all public acute hospitals and some acute private hospitals).
* All e-DRG discharges from April 2004 are now coded using ICD-10-AM.
*The ICD-10-AM codes using for 2004 - 2008 data are as follows:
CT: Blocks 1952 – 1966.
MR: Blocks 1991 and 2015.

Spain

* Ministerio de Sanidad y Política Social (Ministry of Health and Social Policy). Instituto de Información Sanitaria (Health Information Institute).
* Estadística de Establecimientos Sanitarios con Régimen de Internado (Statistics on Health Establishments providing Inpatient Care). http://www.msps.es/estadEstudios/estadisticas/estHospiInternado/inforAnual/home.htm.
* No data of diagnostic exams in ambulatory care.

Switzerland

* Data not available.

Sweden

* Data not available.

Turkey

General Directorate of Curative Services, Ministry of Health.
* Data include Ministry of Health-affiliated health care facilities, universities and private hospitals.

United Kingdom

* England only back-data taken from Department of Health website, ‘Imaging and Radiodiagnostics’: http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalActivityStatistics/DH_077487.
* Data for England only.
* Data are for financial years, i.e. 2008 data is 2008/09.
* Raw numbers of exams for 1995-2008 have been increased pro-rata by the OECD Secretariat to provide appropriate numbers for the UK, enabling the correct computation of rates using the UK population data stored within the database.
* Hospital data for England only at http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalActivityStatistics/DH_077487

United States

2007 Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) Census. Benchmark Report: IMV, Limited, Medical Information Division, 2007: Installed Base of CT Scanners: Installed Base of MRI Scanners. (www.imvlimited.com/mid/census_dbase.html#).
Coverage:
* Nationwide- census study sites. IMV CT/MRI census is a telephone survey used to query all sampled hospital and non-hospital sites in the United States performing CT and MRI procedures.
* Candidate sites (MRI/CT) are identified in the American Hospital Association’s AHA guide - The AHA Guide to the Health Care Field. The AHA information is supplemented by registrations lists of CT installations from the Food and Drug Administration, proprietary IMV lists and site lists identified through secondary research. Survey respondents are asked to identify other sites in their service areas. Responses are checked against the database and newly identified sites are verified and added to the database.
* A source of error in the sample is the possible omission of sites from the universe of all CT/MRI sites, which have thus far still escaped identification, particularly non-hospital sites.
* US territories are not included.
* Estimation: CT- Estimates are based on 60% of the whole body of identified sites.
* Estimates include hospital based and non-hospital sites.
* Estimates include fixed and mobile CT and MRI installations.
Periodicity: Data collected on a biennial basis.
Deviation from the definition: Data do not match OECD definition. Rather than CT exams (MRI exams) in ambulatory care, data represent CT exams (MRI exams) in non-hospitals. Most of the CT's and MRI's performed "in hospitals" are on an outpatient basis.
Deviation from the calculation method: Calculation methods match OECD definition.
* For any given year of the IMV census, the number of sites (MRI/CT) is based on those identified in the prior year census, plus newly identified sites, minus those that had closed or no longer perform CT or are not short-term general hospitals.

                                                                                         

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Source ECO-SANTÉ OCDE 2010, Juin	Dernière révision de cette page : 23/06/2010