Appropriateness and Budget Limitations: Effects on the Use of Cardiac Imaging Techniques

Abstract

In recent years, increasing economical limitations resulted in a general reduction in health care spending possibilities and, finally, in budget limitations. The potential impact of these economical restrictions on cardiac imaging is discussed. Imaging techniques are responsible of a consistent amount of the health care spending, in particular cardiovascular imaging techniques and, among them, radionuclide imaging modalities. To contain costs, the focus of payers, scientific societies, and political organizations is mainly set to reduce the number of exam, mainly by acting on inappropriate testing, that is the overuse. However, the underuse, which consists in studies that actually are indicated, according to guidelines, but are not performed, is also responsible of a possible rise in long-term costs for the health care system through missing early diagnosis and thus not preventing possible events in high risk subjects. Because of budget constraint, actions to reduce the number of cardiac imaging studies by improving the appropriateness of the indications and to contain investments in hardware and software upgrading are promoted. A different approach is discussed.