1. Forecasting Demand for CT / MRI / US April 2007 A. Bouthillier A. Meleshko P. Wares

2. Outline Problem Scope Approach Data Collection Data Analysis & Results Summary

3. 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

4. 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

5. Collect qualitative & quantitative data scans completed + change in waitlist monthly demand Analyze demand patterns for effect of variables Compose forecast, confer with experts Approach

6. Data Collection – Qualitative: Interviews with Industry Experts Factors Questionnaire – Quantitative: Capital Health statistics Other research

7. 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

8. 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

9. 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

10. Images Courtesy of Alberta Wellness, 2007 Changes in Market Share

11. 3 CT’s added (Aspen region)  27.4% decrease of Aspen residents

13. Supply-Induced Demand Wait Time vs. Demand –CT and MRI –Percentage changes –Removal of outliers –Various lags and groupings

15. New Technologies Exams/patient ratio –Decrease for MRI (1.4 to 1.2) –Increase for CT (1.3 to 1.4)

17. New Treatments Adoption rate of previous procedures Number of scans completed as a percentage of total cases diagnosed Diagnostic Grouping Code  Scan Categories

21. Forecast

22. Relative Impact

23. Factor% Increasing Affliction Rates40 Changing physician behaviours25 Supply-Induced Demand20 New Treatments15 New Technology5 Change in Market Shares-5 CT

24. Factor% Increasing Affliction Rates40 Supply-Induced Demand25 Changing physician behaviours23 New Treatments10 New Technology5 Change in Market Shares-3 MRI

25. Factor% Increasing Affliction Rates35 Changing physician behaviours30 New Treatments25 Supply-Induced Demand5 New Technology5 Change in Market Shares0 US

26. 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

27. Questions?