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has been a concerted effort over the last 5-10 years to study the utilization rate of IR in Canada. The purpose of this report is to share some of the key results of this investigation, in the hopes that your region can learn from our shortcomings.

UTILIZATION OF INTERVENTIONAL RADIOLOGY IN CANADA Approximately six years ago, the Canadian Interventional Radiology commissioned the Millenium Research Group Inc., a medical devices market research company, to study the utilization of IR services in Canada. The resultant 209-page report was completed in March 2006, and several of the key findings republished the following year. The report found that among the G7 countries (Canada, France, Germany, Italy, Japan, UK, and USA), Canada performed the fewest IR procedures per capita in 2005, while the USA performed the most, with Canada performing between just over the a third of the procedures the US performed. This gap was expected to widen in the subsequent five years. The report went on to calculate the estimated impact of this under-utilization, specifically focusing on eight pathologies and intervention categories – peripheral arterial disease (iliac), peripheral arterial disease (lower extremity), abdominal aortic aneurysm/EVAR, ischemic stroke,

cerebral aneurysm, uterine fibroids, vertebral fracture/vertebroplasty, and liver cancer. The report estimated the proportion of cases in Canada where surgical approaches were performed instead of IR approaches, the proportion of cases where the corresponding IR approach would have been suitable, and the potential decrease in complications and increase in healthcare savings had an IR approach been used instead. The results were striking. Solely for these

eight pathologies, the report estimated that had an IR approach been used instead, where appropriate, an additional 402 lives could have been saved, $180.3 million dollars

in treatment dollars saved, over $92.3 million in societal dollars saved, and 98,010 hospital bed-days saved, annually. The underutilization of IR in Canada was

clearly having a significant impact both on patients directly, and on healthcare costs.

CAUSES OF UNDERUTILIZATION A number of projects have been performed in Canada to attempt to elucidate the causes of this underutilization, and impediments to future growth, from the perspective of Interventional Radiologists. The causes may not be particularly surprising to readers, and likely common to many countries. However, we felt it prudent to have clear evidence documenting the impediments in order to be able to more forcefully approach government and healthcare officials when the time came. In many cases, Interventional Radiologists in Canada wished to perform additional procedures they currently did or could not offer such as radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%).

Impediments identified included a lack of manpower, including IR nurses, IR technologists, and Interventional Radiologists themselves, a lack of protected clinical time (including office 

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