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Diagnostic imaging capacity by country – and its impact on mortality

Diagnostic imaging capacity varies significantly by country, even amongst rich nations. Using OECD data, we look at how the number of CT scanners and MRI scanners per million inhabitants varies between 39 OECD+ countries, and whether this has an impact on avoidable mortality for 27 of those countries. We used 2019 data, to avoid any distortion from Covid.

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Rich countries tend to have greater diagnostic imaging capacity than poorer countries. The US has almost seven times more CT capacity per head than Mexico, and almost 14 times more MRI capacity per head. Germany has 3.7 times the per-head CT capacity as Hungary, and seven times the MRI capacity. Japan has by far the most capacity of both CT and MRI scanners.

However, there are some notable outliers to this trend. Brazil and several Eastern European countries have significantly greater capacity than Israel. Canada also has much smaller capacity than you would expect based on how rich it is.

Another striking trend is that almost every country has significantly greater CT capacity than MRI capacity. Out of the 39 countries, Finland and Switzerland were the only one to have more MRI than CT scanners per head. The likely explanation for this is that, of the two modalities, MRI is the more expensive.

Do the differences in CT and MRI capacity have an impact on avoidable mortality? At first glance it would appear that MRI capacity does, whilst CT capacity does not: there is a weak negative correlation between MRI capacity and avoidable mortality, but no correlation between CT capacity and avoidable mortality.

But when you control for per capita expenditure on health care by country, the picture becomes quite different. Running a multiple regression with CT capacity, MRI capacity and 2019 per capita health expenditure (in purchasing power parity-adjusted dollars) as predictors for avoidable mortality in 2019, only per capita health expenditure is anywhere close to being a statistically significant predictor.

The correlation between MRI capacity and avoidable mortality appears to be due to MRI capacity being much more tightly linked to a country’s per capita health expenditure.

This doesn’t mean that MRI capacity has no impact at all on avoidable mortality. But, especially given how expensive MRI machinery is, it does suggest that there may be other ways of reducing avoidable mortality which might have a much greater per-dollar impact. It’s particularly notable that out of the countries analysed Israel – which is perhaps the only country in the world where a sophisticated AI-enabled preventive health care model is being practiced at scale – has one of the lowest capacities of both MRI and CT and yet also had the lowest rate of avoidable mortality in 2019.

We would welcome your thoughts on this story. Email your views to Martin De Benito Gellner or call 0207 183 3779.