Increase in Utilization of Afterhours Medical Imaging: A Study of Three Canadian Academic Centers

Can Assoc Radiol J. 2015 Nov;66(4):302-9. doi: 10.1016/j.carj.2015.03.002. Epub 2015 Jul 10.

Abstract

Objectives: The objectives of our study were to assess trends in afterhours medical imaging utilization for emergency department (ED) and inpatient (IP) patient populations from 2006-2013, including analysis by modality and specialty and with adjustment for patient volume.

Methods: For this retrospective study, we reviewed the number of CT, MRI, and ultrasound studies performed for the ED and IP patients during the afterhours time period (5pm - 8am on weekdays and 24 hours on weekends and statutory holidays) from 2006-2013 at three different Canadian academic hospitals. We used the Jonckheere-Terpstra (JT) test to determine statistical significance of imaging and patient volume trends. A regression model was used to examine whether there was an increasing trend over time in the volume of imaging tests per 1000 patients.

Results: For all three sites from 2006-2013 during the afterhours time period: There was a statistically significant increasing trend in total medical imaging volume, which also held true when the volumes were assessed by modality and by specialty. There was a statistically significant increasing trend in ED and IP patient volume. When medical imaging volumes were adjusted for patient volumes, there was a statistically significant increasing trend in imaging being performed per patient.

Conclusion: Afterhours medical imaging volumes demonstrated a statistically significant increasing trend at all three sites from 2006-2013 when assessed by total volume, modality, and specialty. During the same time period and at all three sites, the ED and IP patient volumes also demonstrated a statistically significant increasing trend with more medical imaging, however, being performed per patient.

Keywords: Afterhours; Emergency department; Medical imaging; Radiology; Utilization trends; Volume.

MeSH terms

  • Academic Medical Centers / statistics & numerical data*
  • Academic Medical Centers / trends
  • Adult
  • After-Hours Care / statistics & numerical data*
  • After-Hours Care / trends
  • Diagnostic Imaging / statistics & numerical data*
  • Diagnostic Imaging / trends
  • Emergency Service, Hospital / statistics & numerical data
  • Emergency Service, Hospital / trends
  • Forecasting
  • Health Facility Size / statistics & numerical data
  • Health Facility Size / trends
  • Health Services Needs and Demand / statistics & numerical data
  • Health Services Needs and Demand / trends
  • Hospital Bed Capacity / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Length of Stay / trends
  • Medicine / statistics & numerical data
  • Medicine / trends
  • Ontario
  • Utilization Review / statistics & numerical data
  • Utilization Review / trends