How will 18% population growth led by the aging show up in U.S. radiology utilization?

If demography is indeed destiny, U.S. healthcare is headed for a major escalation in spending on medical imaging over the next three decades, according to a study published online June 1 in the American Journal of Roentgenology.

Emory University researchers Michal Horný, PhD, and Richard Duszak Jr., MD, arrived at the conclusion [1] after analyzing 2018 imaging claims from 26.2 million individuals aged newborn to 64 years old and 1.1 million individuals aged 65 to 118.

Alert to U.S. Census Bureau data pointing to 18% population growth between now and 2050—from 331 million to 389 million residents—Horný and Duszak entered the exercise similarly mindful of the overall aging of the population.

Population expansion, they comment in their introduction, “will not be uniform, with most growth projected among individuals 40 to 50 years old and 65 years old and up.”

Limiting their inquiry to healthcare consumers covered by employer-sponsored insurance, Horný and Duszak analyzed imaging spending by sex as well as age. They tapped databases compiled by IBM MarketScan and Medicare’s employer-sponsored plan branch.

Their key findings:

  • Among newborns, mean annual imaging spending was $299 for boys and $270 for girls. After year one, mean spending dropped to $116 for boys and $102 for girls, then steadily grew with age for both sexes until age 13.
  • Between ages 14 and 70, mean annual spending on imaging was higher for women than men. Mean spending on imaging increased with age for both until approximately age 80 to 85, when it peaked at $1,559 for men and $1,415 for women.
  • Imaging comprised the smallest proportion of spending on healthcare services among newborns at 2.02% for boys and 2.12% for girls.
  • Imaging accounted for the largest share of spending on healthcare services at age 38 for men at 9.0% and age 44 for women at 12.4%.

Meanwhile, in a middle-aged subset—individuals 40 to 64 years old—the proportion of healthcare spending devoted to imaging was substantially higher among women than men.

Horný and Duszak note the consistency of their imaging-utilization findings with those from prior research that looked at U.S. patient populations from 1996 to 2010 and 2000 to 2009.

They also acknowledge the questionable generalizability of their findings to the uninsured as well as healthcare consumers covered by Medicaid and other Medicare plans.

Another limitation: IBM MarketScan omits sociodemographic details such as race, ethnicity and income, so the team was unable to break out predictive figures on underrepresented populations.

“Our findings suggest that spending on medical imaging could increase substantially due solely to changes in the age and gender distribution of the U.S. population as a result of the 18% population growth projected by 2050,” Horný and Duszak conclude. “Therefore, researchers evaluating medical imaging costs and cost growth should consider demographic changes in their studied populations because it may be a powerful yet uncontrollable factor driving use and associated spending.”

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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