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More Canadians are receiving computerized diagnostic imaging tests than a few years ago and the number of machines available is growing, but access still varies greatly by province, according to a report published Thursday by the Canadian Institute for Health Information.



The number of magnetic resonance imaging and computed tomography scans performed in Canada each year falls below that of many other countries in the Organisation for Economic Co-operation and Development, the report found.

The findings highlight persistent problems dogging access to important medical services in Canada and raise more doubts over the way Canada manages its health-care resources.

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Diagnostic imaging, which includes MRI and CT scans, is an important tool that provides a detailed view of organs, bones, tissues and other body parts to help health-care professionals identify disease and other health problems.

Federal and provincial governments pledged in 2004 to minimize lengthy wait times for diagnostic imaging and four other priority areas of health services.

Six years later, some Canadians still face long waits for diagnostic tests.

The report found that, on average, 41 MRIs were performed for every 1,000 people in Canada in 2008-2009, from a high of 54 per 1,000 in Alberta to a low of 23 per 1,000 in Prince Edward Island.

"It's true that our wait time is still too long in many cases," said David Koff, chairman of the radiology department at McMaster University and chief of diagnostic imaging at Hamilton Health Sciences Centre.

Chris Kuchciak, manager of health expenditures at CIHI, said the access disparity could be the result of many factors, such as physician prescribing practices in different provinces, demand for diagnostic tests, or differences in how provincial health systems are set up.

Canada's MRI rate fell behind the OECD average of 48.5 exams per 1,000 people. The United States had one of the highest MRI rates at 91.2 per 1,000, while Australia had one of the lowest at 21.4 per 1,000.

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As for CT scans, in Canada 121 were performed for every 1,000 people in 2008-2009, the report said. PEI and British Columbia had the lowest rates of the provinces, at 104 and 106. New Brunswick had the highest - 193 scans per 1,000.

The OECD average for CT scans in 2008 was 139 per 1,000, with the U.S. average at nearly 228 while the Netherlands had the lowest at 60.

At the same time, the number of MRI and CT scanners available in Canada has risen significantly in recent years. There were 266 MRI machines and 465 CT scanners operating in Canada in January, 2009, up from 222 MRI machines and 419 CT scanners in 2007, the report said.

Most of them are in hospitals - 80 per cent of MRI machines and 95 per cent of CT scanners - while the rest are in clinics.

Some provinces use their machines more than others. Ontario performed 7,873 MRIs per machine in 2008-2009. New Brunswick performed 11,199 CT scans per machine in that time period.

But the numbers don't tell the whole story on their own. Some experts say a major part of the problem contributing to wait times is disorganization or inefficiency within the health-care system.

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A growing number of critics also say Canada, and many other countries, rely too heavily on CT scans. It's a potentially significant problem because CT scans emit high doses of radiation - about 500 times the amount of a single X-ray. (MRIs don't emit radiation because they use magnetic fields and radio waves to generate images).

"There's still a lot of research and work going on to figure out what's an appropriate use of this new technology," Mr. Kuchciak said.

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