Navigation Links
Patient factors play key role in emergency department imaging
Date:6/24/2013

OAK BROOK, Ill. Despite concerns to the contrary, very little of the variation in Emergency Department (ED) imaging utilization is attributable to physician experience, training or gender, according to a new study published online in the journal Radiology.

Imaging exams like X-rays and CT scans are common in the ED. In 2010, slightly more than 47 percent of all ED visits in the United States had an imaging exam associated with them.

"Analyzing and understanding drivers of use of imaging in the ED is important for several reasons," said Christopher L. Sistrom, M.D., M.P.H., Ph.D., from the departments of radiology at Massachusetts General Hospital in Boston and the University of Florida in Gainesville, Fla. "There's a balance of cost and benefits to the patient, institution and payer, as well as the overarching issue of radiation exposure."

Previous studies have found substantial variation in imaging rates across and within EDs, suggesting different tendencies among physicians when ordering imaging. However, much of the existing research is limited, according to Dr. Sistrom.

"A lot of literature on imaging variability can lead to a false assumption that doctors are primarily responsible," he said. "The problem is that it is difficult to fully describe and quantify variability at the different levels it can occur."

In the new study, Dr. Sistrom and colleagues analyzed 88,851 ED visits during 2011 at Massachusetts General Hospital. They used an analytical tool known as hierarchical logistic regression to identify multiple predictors of the probability that imaging was ordered during a given visit.

"That's what makes our paper unique," Dr. Sistrom said. "Hierarchal modeling allows us to ask very specific questions about the relative contributions of various factors to imaging use."

The overall rate of imaging utilization in the Massachusetts General ED was 45.4 percent in 2011, similar to the 2010 national average of 47.2 percent. Analysis of the data revealed that physician-related factors like gender, experience and training did not correlate with imaging use.

"The key finding in our study is that doctors don't make much difference in imaging utilization," Dr. Sistrom said. "Our data showed that doctors are responsible for about one percent of the variability in probability of having an imaging exam during an ED visit."

Instead, patient and visit factors were the predominant predictors of the likelihood of imaging for a given ED visit. These factors include prior visit, referral source, arrival mode and clinical reason for the visit.

The workload of the ED was another significant factor in imaging use. When the ED was the least busy, the odds of low-cost imaging were 11 percent higher than the reference standard. A busier ED resulted in a tendency towards more high-cost imaging.

The new study shows that medical management efforts looking to reduce imaging utilization may be misguided in focusing on remediating ED physicians.

"To reduce imaging utilization, a lot of people in quality improvement and medical management might try to identify high outliers and punish them," Dr. Sistrom said. "In settings like the one we studied, that strategy won't get you anything but angry doctors."


'/>"/>

Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

Related medicine news :

1. Exercise benefits patients with type 2 diabetes
2. Health Insurance for Patients with Mental Illness and Substance Use
3. Jackson, MS Periodontist, Dr. Roger Parkes Brings Gum Disease Patients the FDA-cleared Laser Gum Disease Treatment
4. Dr. Steven Wallach Receives the RealSelf 100 Award for Commitment to Patient Education in Social Media
5. New optical metrics can identify patients on fast track to decreased vision
6. Pediatric practices can offer smoking cessation assistance to parents of their patients
7. Online USA Doctors Launches a Platform Where Patients Can Find Quick Answers to All Their Health Related Questions and Find Healthcare Information Online
8. New analysis shows that patients with Type 2 diabetes and mild renal impairment had similar improvement in blood sugar control and experienced less hypoglycemia with JANUVIA (sitagliptin) compared to sulfonylurea
9. hCG Treatments / Diet Doc hCG Diets Announces New Diet Plans to Help Patient’s Avoid Hearing Loss Resulting from Obesity
10. Medical Offices to Feel Pain as Aging Baby Boomers and Affordable Care Act Expand Pool of Patients: 3 Tips from Appointment-Plus to Improve Efficiency
11. Global Pioneers in Patient Advocacy, Regulation and Research to Speak at DIA Meeting
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/24/2016)... ... May 24, 2016 , ... ... corporate identity and website at its “Transforming Outcomes” User Conference in Las Vegas ... reflect i2i’s ongoing success to set the market standard for meaningful population health ...
(Date:5/24/2016)... ... May 24, 2016 , ... ... of communication enabled solutions and managed services today announced a strategic partnership ... enterprise contact center market. , Altura, one of Avaya’s largest Platinum Business ...
(Date:5/24/2016)... Church, VA (PRWEB) , ... May 24, 2016 , ... ... 14-15, 2016 · Raleigh, NC, http://www.fdanews.com/humanerrordrugdevice , Human error is known to ... is unlikely that human error will ever be totally eliminated, many human performance problems ...
(Date:5/24/2016)... ... ... Regenerative Medicine is being transformed by ongoing research and clinical findings at ... results as have been achieved with Okyanos Cell Therapy are paving the ... patients worldwide. , As the Medical Advisory Chairman at Okyanos, Eric Duckers, MD, PhD, ...
(Date:5/24/2016)... ... May 24, 2016 , ... ... or injury that focuses on repairing the musculoskeletal and neuromuscular systems of the ... on functional restoration, NYDNRehab began providing treatments for physical therapy in New York, ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)... , May 24, 2016 ... den Markt gebracht, die es Ärzten erlaubt, ihre ... zu behandeln: MDLinking kombiniert Live Streaming mit einer ... Umfeld zu kommunizieren. Mediziner in Europa, Afrika, Asien ... sich bereits für die Plattform registriert. ...
(Date:5/24/2016)... CHRISTCHURCH, New Zealand , May 24, 2016 ... scanning and informatics solutions for the healthcare sector, has been ... the New Zealand Hi-Tech Awards 2016. Dr ... a fantastic acknowledgement for our team.  It,s really good to ... the burden healthcare internationally. Our products are used in 35 ...
(Date:5/24/2016)... , May 24, 2016 ... de doble terapia del mundo, introduce catéteres para ... OrbusNeich, una compañía global especializada en ... vidas, ha expandido su cartera incluyendo productos para ... JADE™ y Scoreflex™ PTA son los dispositivos de ...
Breaking Medicine Technology: