Cost-effectiveness of sonography in India

Acad Radio11996;3:$111-$112 9 1996, Association of University Radiolog!sts A mong all tile new technologies, sonography remains an important imaging technique in several areas of medicine. In a developing country such as India, this is even more true, and sonography is well accepted as a diagnostic imaging technique. The number of sonographic examinations per day is increasing rapidly, and, in many cases, sonograpl W is replacing other imaging techniques. This is essentially because of tile simple and noninvasive nature of the examination and society's increasing awareness of the hazards of radiation. Economics also played a significant role in the establishment of sonography as the preferred imaging technique in India. The sale of sonograph{c equipment in the private sector is booming, and government and armed forces hospitals are not lagging far behind. The" population of India is 930 million, and the growth rate is 2.0% per annum. The population, spread over an area of 3.3 million square kilometers, is distributed over 26 states. Seventy percent of the people live in remote villages. Although many languages and numerot~s dialects make communication and dissemination of information complex, the recent use of audiovisual media has helped in reaching remote areas. New Delhi (the cap: ital), Bombay, Madras, and Calcutta are the four major cities in India. Such metropolitan areas, with sophisticated high-rise buildings and well-equipped hospitals, are in sharp contrast to tile huts, thatched-roof houses, and streetside doctors of the villages. The current aim of Indian health authorities is to provide health care tO the 70% of people living in these villages.. Sonography, of all the newer imaging technologies, has had the greatest impact in this type of environment, both urban and rural. It was first introduced in India by a group of cardiologists, and it has since become the most frequently requested diagnostic radiology test. Indeed, it is so w, d l accepted that it has virtually become a household word. By offering lowcost diagnosis (computed tomography [CT] scanning, magnetic resonan~ e [blR] imaging, and other technologies are out of reach financially for more than 90% of our population), sonography plays a vital role in the modern practice of radiology in India. As a result of tile economic and social environment in India, a wide and varied spectrum of diseases plague our population, making diagnosis an obvious challenge to the sonographer . I expect sonography to long remain tile most suitable and affordable screening technique at our d!sposal.