MacEwan D W
Department of Radiology, University of Manitoba Health Sciences Centre, Winnipeg.
Can Assoc Radiol J. 1998 Jun;49(3):152-60.
As a result of the reform of a comprehensive government health plan, an integrated imaging system is being created in the province of Manitoba. The intent of the system is to reduce costs, avoid causing harm to patients, enhance physician referral services and add new programs.
Evaluation of trends in examinations, equipment, personnel, expenditures and policy in the 1992-93 and 1995-96 fiscal years in Manitoba.
The population has remained steady, at 1.1 million. Hospitals have been amalgamated under new authorities, and Manitoba's annual health care spending of $1.8 billion has been reduced by $235 million. Between the 2 years, use of radiography declined from 835,748 to 726,394 examinations per year. Use of mammography, ultrasonography, computed tomography, magnetic resonance imaging and nuclear medicine increased moderately. The total number of radiologic examinations declined from 1,069,579 to 975,044. There was little change in equipment, but the plant aged as a result of freezes on construction and capital spending. Personnel declined by 20 full-time equivalent positions, from 794.3 in 1992-93 to 774.3 in 1995-96. Savings in operations were made as a result of hospital budget restrictions. Total expenditures declined from $100 million to $89 million. The income of imaging specialists did not change because they were paid higher fees for examinations involving newer technology.
Integration of rural/northern and urban hospital services has followed the plan set out in recent legislation. Savings of up to 20% are expected to be realized through reduction in personnel (saving $1 million), group tendering ($1 million), in-house repair ($1 million), reduction in deployment of equipment ($3 million), integration of services ($1 million), indirect cost reduction ($5 million), practice guidelines ($3.5 million), reduced breast screening costs ($1 million), physician payment reform ($1 million) and rigorous clinical/fiscal audit ($1 million).
作为政府全面医疗计划改革的结果，曼尼托巴省正在创建一个综合成像系统。该系统的目的是降低成本、避免对患者造成伤害、加强医生转诊服务并增加新的项目。
对曼尼托巴省1992 - 93财年和1995 - 96财年的检查、设备、人员、支出及政策趋势进行评估。
人口保持稳定，为110万。医院已在新的管理机构下合并，曼尼托巴省每年18亿加元的医疗保健支出减少了2.35亿加元。在这两年间，每年的X光检查使用量从835,748次降至726,394次。乳房X光检查、超声检查、计算机断层扫描、磁共振成像和核医学的使用量适度增加。放射检查的总数从1,069,579次降至975,044次。设备变化不大，但由于建筑和资本支出冻结，设备老化。人员减少了20个全职等效岗位，从1992 - 93年的794.3个降至1995 - 96年的774.3个。由于医院预算限制，运营方面实现了节约。总支出从1亿加元降至8900万加元。成像专家的收入没有变化，因为他们在涉及新技术的检查中获得了更高的费用。
农村/北部和城市医院服务的整合遵循了近期立法中规定的计划。预计通过人员减少（节省100万加元）、集中招标（100万加元）、内部维修（100万加元）、设备配置减少（300万加元）、服务整合（100万加元）、间接成本降低（500万加元）、实践指南（350万加元）、乳房筛查成本降低（100万加元）、医生薪酬改革（100万加元）和严格的临床/财务审计（100万加元），可实现高达20%的节约。
