| Popis: |
Access to timely healthcare is a central issue in Canada. In 2002, the Romanow report stated that diagnostic imaging wait times were increasing at a high rate and patients were consulting newly formed private MRI clinics. Recently, the Federal Advisor on Wait Times released his final report (Postl 2006) highlighting the continuing issue of increasing wait times despite the injection of resources following the 2004 First Ministers' meeting. Indeed, the issue of wait times, the report concludes, cannot be determined independently of the rest of the healthcare system. Wait times for high-technology services continue to be lengthy despite enhanced federal funding (Romanow 2002; Esmail and Walker 2002). Long waits for MRI procedures have garnered particular attention because of the technology's broad clinical indications (Keller 2005; CIHI 2004; Ehman 2004a). Since MRIs are critically important in diagnosing many conditions that require superior image resolution, the evidence that Canada has fewer MRI machines per capita than most developed countries is a potential concern for the public because of slower diagnostic time and reduced ability to monitor disease progression (Keller 2005; CIHI 2004; Ehman 2004a). The increased demand for MRIs and relative lack of public funding has provided the incentive for private groups in many provinces throughout Canada to open MRI facilities (Fischer 2005; Brooks 1993, 1994; Moran 1994). The move to private MRI centres has been controversial because some feel it challenges our long-standing model of universal access and the public delivery of healthcare. Similarly, offering privately funded MRIs suggests that, in some respects, a two-tiered model may be emerging (Brooks 1994). Many point to the increased utilization of private MRI centres as justification for the relaxation of government controls on private medicine (Pinker 2000; CBC News 2002). However, as compared to the detailed information on public MRI services, relatively little is known about the utilization of private MRI facilities (Pindera 2004). One of the main reasons is that there is no single governing body, whether provincial or federal, that regulates the delivery of private healthcare. Estimating the extent and volume of privately delivered MRIs is central to understanding the magnitude and future impact of this technology on our public healthcare system. Therefore, the main goals of the current investigation involved surveying public and private MRI facilities to determine (a) hours of operation, a measure that would serve as a surrogate for procedure volume, and (b) estimated wait time for a standard elective MRI study. |
