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ICES study finds wealthy Ontarians have better access to MRI scans

March 3, 2009 Toronto

Ontario wait times for Magnetic Resonance Imaging (MRI) have improved since the provincial government’s Wait Time Strategy began in 2004. But a study out of the Institute for Clinical Evaluative Sciences (ICES) has found wealthy Ontarians are now 38 per cent more likely to receive MRI scans than their poorer counterparts.

The study of 1,356,750 outpatient MRI scans done in Ontario between April 1, 2002 and March 31, 2007 found:

  • At the beginning of the study, before Ontario’s Wait Times Strategy began, a gap in access to MRI scans based on income existed. Patients living in the richest one-fifth of Ontario neighbourhoods were 25 per cent more likely to receive MRI scans than those living in the poorest one-fifth of neighbourhoods.
  • During the next five years, during which approximately $118-million in Wait Times spending was injected for MRI services between November 2004 and March 2008, the annual number of MRI scans performed in Ontario doubled.
  • However, the increase in MRI use over the five-year period was largest for those in the wealthiest Ontario neighbourhoods, so that the gap in access to MRI between rich and poor widened. Patients living in the richest neighbourhoods are now 38% more likely to receive MRI scans than those in the poorest neighbourhoods.
  • So, while Ontario’s Wait Times Strategy has improved access to MRI, the findings suggest the improvements in access have not occurred equally amongst all Ontarians.

“We already knew from previous work that there was greater access to MRI scans for richer Ontarians. This study shows that access has improved but it looks like it has not been shared equally,” says principal investigator and ICES scientist, Dr. John You. “It’s well known that, on average, poor people have more health problems than the rich, so the trends go against what we would have expected,” says You, who is also an assistant professor of medicine and clinical epidemiology and biostatistics at McMaster University. “Although many of us pride ourselves on Ontario’s universal hospital and physician services, our study highlights the need for simultaneous strategies that aim to improve the appropriateness of MRI scanning, so that access is based on medical need.”

Author affiliations: ICES (Dr.You, Dr.Laupacis); McMaster University (Dr. You, Dr. Venkatesh); Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital (Dr. Laupacis) and University of Toronto (Dr. Laupacis), Ontario.

The study “Better access to outpatient magnetic resonance imaging in Ontario - but for whom?” is in the March 3, 2009 issue of Open Medicine.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians,and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.