Transcript Forecasting Demand for CT/MRI/US

Forecasting Demand for
CT / MRI / US
A. Bouthillier
A. Meleshko
P. Wares
April 2007
Outline
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Problem
Scope
Approach
Data Collection
Data Analysis & Results
Summary
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
Scope
Magnetic Resonance Imaging (All Sites)
2002/0 3
2003/0 4
2004/0 5
2005/0 6
2006/0 7
2007/0 8
2008/0 9
2009/1 0
2010/1 1
2011/1 2
12
Focus on how factors beyond population
growth affect demand forLinear
CT,Forecast
MRI, and US
11
10
Exams ('000)
Factors we examined:
9
8
7
6
5
1. Changes in market share Population Based Forecast
2. Latent demand
Regression Line
Historical Data
3. New technologies
4. New treatments
5. Increasing affliction rates
6. Changing behaviours of physicians
Graphed by Two-Month Period
Approach
• Collect qualitative & quantitative data
scans completed
+ change in waitlist
monthly demand
• Analyze demand patterns for effect of
variables
• Compose forecast, confer with experts
Data Collection
– Qualitative:
• Interviews with Industry Experts
• Factors Questionnaire
– Quantitative:
• Capital Health statistics
• Other research
Qualitative Data Collection
• Interviews with Industry Experts:
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
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
Data Analysis & Conclusions
1. Changes in Market Share
Aspen Health
2. Supply Induced Demand
Beta Analysis
3. New Technologies
Exam/Patient Ratios
4. New Treatments
Adoption Rates
5. Increasing Affliction Rates
6. Changing Physician behaviours
Changes in Market Share
Images Courtesy of Alberta Wellness, 2007
Changes in Market Share
• 3 CT’s added (Aspen region)
 27.4% decrease of Aspen residents
20
0
20 2-0
0 1
20 2-0
0 2
20 2-0
0 3
20 2-0
0 4
20 2-0
0 5
20 2-0
0 6
20 3-0
0 1
20 3-0
0 2
20 3-0
0 3
20 3-0
0 4
20 3-0
0 5
20 3-0
0 6
20 4-0
0 1
20 4-0
0 2
20 4-0
0 3
20 4-0
0 4
20 4-0
0 5
20 4-0
0 6
20 5-0
0 1
20 5-0
0 2
20 5-0
0 3
20 5-0
0 4
20 5-0
0 5
20 5-0
0 6
20 6-0
0 1
20 6-0
0 2
20 6-0
0 3
20 6-0
0 4
20 6-0
06 5
-0
6
Percentage of Capital Health CT Exams
Percentage of Capital Health CT Exams Provided to Aspen Health Residents
(2 Month Periods, Jan 2002 - Jan 2007)
10.0%
6.0%
5.0%
Feb 2004: Cold Lake
and Hinton CTs Installed
9.0%
8.0%
7.0%
Mar 2004: Westlock
CT Installed
4.0%
3.0%
Percentage of CT Exams by 2
Month Period
2.0%
Linear Regression
1.0%
0.0%
Time
Supply-Induced Demand
• Wait Time vs. Demand
– CT and MRI
– Percentage changes
– Removal of outliers
– Various lags and groupings
MRI - Percent Change in Wait Time and Percent Change in Demand
100.0%
80.0%
Change in Demand (%)
60.0%
40.0%
20.0%
-50.0%
-40.0%
-30.0%
-20.0%
0.0%
-10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
-20.0%
-40.0%
-60.0%
-80.0%
-100.0%
Change in Wait Time (%)
Priority 1
Priority 2
Priority 3
Total
2&3
50.0%
New Technologies
• Exams/patient ratio
– Decrease for MRI (1.4 to 1.2)
– Increase for CT (1.3 to 1.4)
MRI and CT Exam Per Patient Ratios (Grouped by Quarter)
1.80
1.70
1.60
1.40
1.30
1.20
1.10
MRI Exams Per Patient
CT Exams Per Patients
1.00
0.90
Quarter
-2
06
20
-2
05
20
-2
20
04
-2
03
20
-2
02
20
-2
01
20
00
-2
0.80
20
Exams Per Patient
1.50
New Treatments
• Adoption rate of previous procedures
• Number of scans completed as a percentage of
total cases diagnosed
• Diagnostic Grouping Code  Scan Categories
Cardiac MRI and Cardiac US as a Percentage of Capital Health Heart
Disease Diagnoses
50%
Cardiac US
30%
Cardiac MRI
20%
y = 0.0149Ln(x) - 0.0213
10%
R2 = 0.5725
Month
20
08
-1
0
-4
08
20
20
07
-1
0
-4
07
20
-1
0
20
06
-0
4
20
06
-1
0
20
05
-0
4
20
05
-1
0
20
04
-0
4
20
04
-1
0
20
03
-0
4
20
03
-1
0
20
02
-0
4
20
02
-1
0
01
20
01
-0
4
0%
20
Percentage (%)
40%
Monthly Average
Growth
35 – 40%
15 – 20%
30 – 35%
10 – 15%
25 – 30%
5 – 10%
20 – 25%
0 – 5%
Month
20
07
-1
0
-4
-1
0
-0
4
-1
0
-0
4
-1
0
-0
4
-1
0
-0
4
-1
0
-0
4
-1
0
-0
4
20
07
20
06
20
06
20
05
20
05
20
04
20
04
20
03
20
03
20
02
20
02
20
01
20
01
10%
0%
Number of Chest, Abdomen, and Pelvis CT and MRI Exams as a Percentage of
Capital Health Respiratory & Gastrointestinal Disease Cases Diagnoses
90%
80%
70%
50%
40%
30%
CT Chest, Abdomen, Pelvis
MRI Chest, Abdomen, Pelvis
20%
10%
Month
-1
0
20
06
-0
4
20
06
-1
0
20
05
-0
4
20
05
-1
0
20
04
-0
4
20
04
-1
0
20
03
-0
4
20
03
-1
0
20
02
-0
4
20
02
-1
0
01
20
01
-0
4
0%
20
Percentage (%)
60%
Forecast
Historic and Forecasted Demand for MRI Exams and Population Trend Line
6000
4000
3000
Historic Demand
Historic Trend
2000
Forecast Trend
Forecast
1000
Population Trend
Month
ec
20
11
-D
ec
20
10
-D
ec
20
09
-D
ec
20
08
-D
ec
20
07
-D
ec
-0
6
D
ec
-0
5
D
ec
-0
4
D
ec
-0
3
D
ec
-0
2
D
ec
-0
1
D
ec
-0
0
D
ec
-9
9
0
D
Demand (Scans)
5000
Relative Impact
CT
Factor
%
Increasing Affliction Rates
40
Changing physician behaviours
25
Supply-Induced Demand
20
New Treatments
15
New Technology
5
Change in Market Shares
-5
MRI
Factor
%
Increasing Affliction Rates
40
Supply-Induced Demand
25
Changing physician behaviours
23
New Treatments
10
New Technology
5
Change in Market Shares
-3
US
Factor
%
Increasing Affliction Rates
35
Changing physician behaviours
30
New Treatments
25
Supply-Induced Demand
5
New Technology
5
Change in Market Shares
0
Summary
- Factors besides population growth
leading to demand for CT, MRI, US
- Focus on 6 factors
- Qualitative and Quantitative Data
- Effect of Market Share, SupplyInduced Demand, Adoption Rate
- Relative impact of factors
Questions?