Report predicts thaw in deep freeze of new equipment installations

Despite a dismal start to 2009, most U.S. hospital radiology administrators expect restrictions against capital acquisitions to ease, giving them a chance to address their most pressing needs and acquire diagnostic imaging equipment later this year.

Such positive news in a study of 250 acute care hospitals is tempered by the relatively bad position many facilities were forced into because of the 2008 credit crunch. About 70% of the hospital radiology departments surveyed had implemented partial or total capital equipment spending freezes, according to Mary C. Patton, director of market research at IMV, a healthcare market research firm in Des Plaines, IL, that conducted the survey.

Such policies were typically enforced after capital budgets had already been slashed on average by 20% from actual 2008 expenditures. The survey found that hospitals generally spent less on imaging equipment than they had budgeted in 2008. Spending declined sharply as the national financial crisis deepened in the second half of the year, Patton said.

"In 2009, capital budgeting thus far has been an issue because of partial or complete freezes, so budgets have gone out the window. Budgets are a moot point," she said in an interview.

Still, many radiology administrators told IMV that they plan to buy selected imaging equipment this year. Digital mammography, digital radiography, fluoroscopy equipment, and multislice CT scanners with 64 or more detectors were listed as high-priority items.

IMV's 2009 Diagnostic Imaging Procedures and Purchases report included other highlights:
• Planned imaging equipment purchase delays have been more common than cancellations.
• Radiology departments are planning to upgrade their image storage and management capabilities from analog to digital technologies.
• Two of five current PACS users -- especially 400+-bed hospitals -- plan to purchase one of more PACS upgrades in the next two years.
• Eight of 10 radiology administrators refuse to downgrade their expectations about the level of technology or types of features they demand from their imaging equipment.
• Two of three radiology administrators report that their hospitals will implement selected capital projects in 2009, despite the recession.

On average, hospital-based imaging volume grew in the first quarter of 2009, compared with the same period in 2008. Demand rose from 5% to 10% for CT, digital radiography, non-ob/gyn ultrasound, MRI, and PET. Utilization fell for film-based general x-ray, cardiac catheterization, and fluoroscopy.

Despite utilization growth, hospitals are having more trouble turning a profit from imaging services, according to Patton.

"Reimbursement is becoming more difficult. There is pressure from precertification, including more denials. In areas of high unemployment, hospitals are seeing more self-paying patients and more bad debt," she said.