forecasting demand for ct / mri / us april 2007 a. bouthillier a. meleshko p. wares
TRANSCRIPT
![Page 1: Forecasting Demand for CT / MRI / US April 2007 A. Bouthillier A. Meleshko P. Wares](https://reader035.vdocuments.us/reader035/viewer/2022070412/56649dd45503460f94acc8d6/html5/thumbnails/1.jpg)
Forecasting Demand for
CT / MRI / US
April 2007
A. Bouthillier
A. Meleshko
P. Wares
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Outline
• Problem
• Scope
• Approach
• Data Collection
• Data Analysis & Results
• Summary
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Problem
• Capital Health serves a population of ~ 1M
• High increase in use of Diagnostic Imaging
• Growing waitlist– Public concern – Pressure from physicians, government
• Required:– Demand forecast next 5 years– Factors influencing demand relative impact
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Scope
Focus on how factors beyond population growth affect demand for CT, MRI, and US
Factors we examined:1. Changes in market share
2. Latent demand
3. New technologies
4. New treatments
5. Increasing affliction rates
6. Changing behaviours of physicians
Magnetic Resonance Imaging (All Sites)
5
6
7
8
9
10
11
12
2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12
Graphed by Two-Month Period
Ex
am
s (
'00
0)
Population Based Forecast
Linear Forecast
Historical DataRegression Line
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• Collect qualitative & quantitative data
scans completed + change in waitlist monthly demand
• Analyze demand patterns for effect of variables
• Compose forecast, confer with experts
Approach
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Data Collection
– Qualitative:• Interviews with Industry Experts• Factors Questionnaire
– Quantitative: • Capital Health statistics• Other research
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• Interviews with Industry Experts:
Qualitative Data Collection
1. Changes in market share
2. Supply-induced demand
3. New technologies
4. New treatments
5. Increasing affliction rates
6. Changing behaviours of physicians
• Factor weightings from questionnaires
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Quantitative Data Collection
• Capital Health Data– Population-based scan forecast– Waitlist numbers and times (MRI & CT)– Exams completed & patients served– CT & MRI units in Alberta– Patients served by Capital Health from other
regions
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Data Analysis & Conclusions
1. Changes in Market Share
2. Supply Induced Demand
3. New Technologies
4. New Treatments
5. Increasing Affliction Rates
6. Changing Physician behaviours
Aspen Health
Beta Analysis
Exam/Patient Ratios
Adoption Rates
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Images Courtesy of Alberta Wellness, 2007
Changes in Market Share
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Changes in Market Share
• 3 CT’s added (Aspen region)
27.4% decrease of Aspen residents
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Percentage of Capital Health CT Exams Provided to Aspen Health Residents (2 Month Periods, Jan 2002 - Jan 2007)
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0%
10.0%
2002
-01
2002
-02
2002
-03
2002
-04
2002
-05
2002
-06
2003
-01
2003
-02
2003
-03
2003
-04
2003
-05
2003
-06
2004
-01
2004
-02
2004
-03
2004
-04
2004
-05
2004
-06
2005
-01
2005
-02
2005
-03
2005
-04
2005
-05
2005
-06
2006
-01
2006
-02
2006
-03
2006
-04
2006
-05
2006
-06
Time
Pe
rcen
tag
e o
f C
apit
al H
ealt
h C
T E
xam
s
Percentage of CT Exams by 2Month Period
Linear Regression
Feb 2004: Cold Lake and Hinton CTs Installed
Mar 2004: Westlock CT Installed
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Supply-Induced Demand
• Wait Time vs. Demand – CT and MRI– Percentage changes– Removal of outliers– Various lags and groupings
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MRI - Percent Change in Wait Time and Percent Change in Demand
-100.0%
-80.0%
-60.0%
-40.0%
-20.0%
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
-50.0% -40.0% -30.0% -20.0% -10.0% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0%
Change in Wait Time (%)
Ch
ang
e in
Dem
and
(%
)
Priority 1
Priority 2
Priority 3
Total
2 & 3
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New Technologies
• Exams/patient ratio – Decrease for MRI (1.4 to 1.2)– Increase for CT (1.3 to 1.4)
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MRI and CT Exam Per Patient Ratios (Grouped by Quarter)
0.80
0.90
1.00
1.10
1.20
1.30
1.40
1.50
1.60
1.70
1.80
2000
-2
2001
-2
2002
-2
2003
-2
2004
-2
2005
-2
2006
-2
Quarter
Ex
am
s P
er
Pa
tie
nt
MRI Exams Per Patient
CT Exams Per Patients
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New Treatments
• Adoption rate of previous procedures
• Number of scans completed as a percentage of total cases diagnosed
• Diagnostic Grouping Code Scan Categories
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Cardiac MRI and Cardiac US as a Percentage of Capital Health Heart Disease Diagnoses
y = 0.0149Ln(x) - 0.0213
R2 = 0.5725
0%
10%
20%
30%
40%
50%
2001
-04
2001
-10
2002
-04
2002
-10
2003
-04
2003
-10
2004
-04
2004
-10
2005
-04
2005
-10
2006
-04
2006
-10
2007
-4
2007
-10
2008
-4
2008
-10
Month
Pe
rce
nta
ge
(%
) Cardiac US
Cardiac MRI
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0 – 5%20 – 25%
5 – 10%25 – 30%
10 – 15%30 – 35%
15 – 20%35 – 40%
Monthly Average Growth
0 – 5%20 – 25%
5 – 10%25 – 30%
10 – 15%30 – 35%
15 – 20%35 – 40%
Monthly Average Growth
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Number of Chest, Abdomen, and Pelvis CT and MRI Exams as a Percentage of Capital Health Respiratory & Gastrointestinal Disease Cases Diagnoses
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
2001
-04
2001
-10
2002
-04
2002
-10
2003
-04
2003
-10
2004
-04
2004
-10
2005
-04
2005
-10
2006
-04
2006
-10
Month
Pe
rce
nta
ge
(%
)
CT Chest, Abdomen, Pelvis
MRI Chest, Abdomen, Pelvis
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Forecast
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Relative Impact
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Factor % Increasing Affliction Rates 40
Changing physician behaviours 25
Supply-Induced Demand 20
New Treatments 15
New Technology 5
Change in Market Shares -5
CT
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Factor % Increasing Affliction Rates 40
Supply-Induced Demand 25
Changing physician behaviours 23
New Treatments 10
New Technology 5
Change in Market Shares -3
MRI
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Factor % Increasing Affliction Rates 35
Changing physician behaviours 30
New Treatments 25
Supply-Induced Demand 5
New Technology 5
Change in Market Shares 0
US
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Summary- Factors besides population growth
leading to demand for CT, MRI, US
- Focus on 6 factors
- Qualitative and Quantitative Data
- Effect of Market Share, Supply-Induced Demand, Adoption Rate
- Relative impact of factors
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Questions?