Build it, and they will come. It’s a notion that brings joy to the heart of anyone opening a theater, hotel or restaurant. But to health care executives plugging in a brand-new MRI machine? Turns out they also benefit from the well-known maxim, particularly in one area of California.
At least that’s what Stanford professor Loren Baker discovered. He concluded in an article published in the October edition of Health Affairs that a larger number of MRI machines in one locale is tied to higher use of MRI machines among Medicare patients.
What’s more, greater supply of MRI machines is also tied to higher rates of lower back surgery. The kicker? There is no clear data to prove that lower back surgery is the best option for patients' well being, particularly compounded with the risks of hospital-acquired infections or surgical complications.
Baker's findings offer an important insight into one reason why health care costs are sky-rocketing, as MRI use grows rapidly. The machines fill strip-mall storefronts and tour the nation on big-rig clinics. Baker's findings also raise the question of whether we're talking about money well spent, he said in an interview with California Watch.
Sure, if Baker has knee pain he’d like an MRI, he said. But it’s quite possible that he could pass on the procedure, leave the thousand-plus dollars in his insurance pool and see gradual improvement that comes with time or physical therapy.
“That price tag coupled with some worry that we’re maybe not always getting our money’s worth is where the rubber really meets the road,” Baker said. “We don’t want to stop doing (MRIs) entirely, but we also may not want to keep expanding without paying close attention.”
Baker’s findings build on a larger body of work – pioneered by researchers at Dartmouth – that suggest that higher health care spending doesn't always buy better quality. (To get an interesting eye-full of this notion, check out this graphic by National Geographic showing that U.S. health costs are more than double that of industrialized nations, yet life expectancy is shorter than average.)
Baker said he plans to keep exploring the notion that supply might drive demand in health care, focusing on one area of California that happens to be the MRI capital of the nation. I plan to ask some more questions about that and bring you the answers later this week. Stay tuned – via our Web site or the health and welfare RSS feed.
This article was conceived and produced as a project for The California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communication & Journalism.
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