Comparison of Advanced Imaging Resources, Radiology Workforce, and Payment Methodologies between the United States and Canada | American Journal of Neuroradiology

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Table 1:

Comparing vital and economic statistics of Canada versus US in 2015^{^a}

	Canada	US
Population³⁰	35.8 million	320.9 million
Uninsured (% of total population)⁵⁶	~0%^{^b}	10%
Average life expectancy (yr)²⁶	82.1	78.7
Per capita health care spending^25,27	$4734	$9994
Total health care^25,27	$170 billion	$3.2 trillion
GDP^25,57	$1.6 trillion	$18.1 trillion
Total health care spending (% of GDP)^25,57	11.4	17.7

Note:—GDP indicates gross domestic product.
↵a Currency is in US dollars.
↵b According to the Wellesley Institute report, approximately 200,000–500,000 uninsured individuals reside in Canada. They include students, workers from overseas, undocumented refugees, and newly landed immigrants.⁵⁸

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Table 2:

Examples of differing procedure codes and professional reimbursement for an unenhanced CT of the head in the 10 provinces of Canada^{12–18,59–61}

Province	Fee Code	Professional Fee (CaD$)
British Columbia	08690	44.88
Alberta^{^a}
Saskatchewan^{^b}
Manitoba	7113	49.15
Ontario	X400	43.25
Quebec	08259	33.40
New Brunswick	3166	67.00
Nova Scotia	1105	42.33
Prince Edward Island	8925	83.16
Newfoundland and Labrador	73800	55.53

↵a Benefits for noninvasive diagnostic procedures performed in hospitals and urgent care clinics are payable through hospitals or health authorities.¹²
↵b Not listed in the Payment Schedule for Insured Services Provided by a Physician, October 1, 2017, published by the Government of Saskatchewan.

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Table 3:

Comparison of CT scanner use in Canada versus US (2016)⁶²

Scans	Canada	US
Total CT use (hospital + ambulatory + other)
Total No. (MM)	5.68	82
Per 1000 people	156.6	253.8
Per scanner	10,561.9	6062.8
CT use
CT in hospital setting
Total No. (MM)	5.61	65.7
Per 1000 people	154.4	203.3
Per scanner	8973.8^{^a}	7373.7
CT in ambulatory care setting
Total No.	79,261	16.3 MM
Per 1000 people	2.2	50.4
Per scanner	2735.3^{^a}	3532

Note:—MM indicates million.
↵a Data were obtained in 2012. Remainder are from 2015.

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Table 4:

Comparison of MRI scanner use in Canada versus US (2016)⁶²

Scans	Canada	US
Total MRI use (hospital + ambulatory + other)
Total No. (MM)	2.03	39
Per 1000 people	55.9	120.7
Per scanner	5946.9	3287
MRI use
MRI in hospital setting
Total No. (MM)	1.8	16.5
Per 1000 people	49.4	51.1
Per scanner	6485.6^{^a}	3064.1
MRI in ambulatory care setting
Total No.	234,308	22.5 MM
Per 1000 people	6.5	69.6
Per scanner	3170.9^{^a}	3471.2

↵a Data were obtained in 2012. Remainder are from 2015.

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Table 5:
Neuro CT procedures in 2016 in the US⁶³
CT Procedure Categories Total CT Procedure (MM) % of All CT Procedures % of CT Sites Performing
Spine 6.4 8% 87%
Brain 15.3 19% 94%
Head and neck 7.2 9% 90%
Total neuro CT procedure 28.9 36%
Total CT procedures 82 100%
Note:—Neuro indicates neurologic; MM, million.
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Table 6:
All versus neuro CT and MR scans/1000 people
Scans/1000 People Neuro CT All CT Neuro MRI All MRI
Canada 31^{^a} 156.6 14.2^{^c} 55.9
US 96.4^{^b} 253.8 65.2^{^d} 120.7
Note:—Neuro indicates neurologic.
↵a According to the Canadian Agency for Drugs and Technologies in Health, total neurologic CT examinations were 19.8% of all CT examinations in 2017.
↵b Based on the Medical Information Division benchmark report, total neurologic (spine, brain, and head and neck) CT examinations were 36% of all CT examinations in 2016.
↵c According to the Canadian Agency for Drugs and Technologies in Health, total neurologic MRI examinations were 25.4% of all MR imaging examinations in 2017.
↵d Based on the Medical Information Division benchmark report, total neurologic (spine, brain, and head and neck) CT examinations were 54% of all MR imaging examinations in 2016.

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Table 7:

Neuro MRI procedures in 2016 in the US⁶⁴

MRI Procedure Categories	Total MRI Procedures (MM)	% of All MRI Procedures	% of MRI Sites Performing
Spine	9.5	24%	99%
Brain (nonvascular)	8.8	22%	97%
Head and neck	3.0	8%	84%
Total neuro MRI procedure	21.3	54%
Total MRI procedures	39	100%

Note:—MM indicates million.

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