Outpatient MRI waiting times and the role of self-pay in Austria: bridging the wait gap?

Background

Long waits for magnetic resonance imaging (MRI) compromise patient safety and quality of care, while faster access for self-paying patients raises equity concerns. Although a 20-working-day target for outpatient MRI was introduced in Austria 2018, its implementation in practice remains unclear. This study (i) compares waiting times from phone and online booking under statutory coverage, (ii) assesses compliance with the target, and (iii) quantifies the potential for faster access via self-pay.

Methods

In March-April 2025, we conducted a nationwide field study using standardized simulated-patient phone calls to all Austrian MRI providers contracted with social health insurance (n = 90). The next available MRI appointment was requested for ACL rupture (case 1) and hemochromatosis (case 2). Providers were also asked whether self-pay could shorten waits and at what price. Where available, waiting times were extracted from online booking systems. Group differences in median waits (working days) were tested using Wilcoxon signed-rank and Kruskal-Wallis tests.

Results

Under statutory coverage, median waits via phone booking were 15 days (IQR: 7-27; n = 88) for case 1 and 38 days (IQR: 26-52; n = 82) for case 2. Overall, 60% of providers met the 20-day target in case 1 and 11% in case 2. Online booking showed median waits of 11 days (IQR: 8-16; n = 17) for case 1 and 39 days (IQR: 23-44; n = 7) for case 2. In 13% of calls, providers indicated that self-pay would shorten waits to 1 day (IQR: 1-5) for case 1 and 2 days (IQR: 1-9) for case 2 (both p < 0.01), at mean costs of EUR 315 and EUR 361, respectively. Waits varied between and within federal states.

Conclusions

Austria’s waiting-time maximum was only partially met, with poorer adherence for hemochromatosis than for ACL rupture. While not routinely offered, self-pay can substantially accelerate waits, underscoring the need for transparent monitoring and policies to protect equal access.

Key messages

• MRI waiting times differ markedly by indication, suggesting that timely access under statutory coverage is not consistent across clinical needs.

• Differences between and within federal states indicate uneven MRI access and a need for more central and transparent monitoring of waiting times.