Despite concerns to the contrary, very little of the variation in Emergency Department imaging utilization is attributable to physician experience, training, or gender, according to a new study published online in the journal Radiology.
Imaging exams such as x-rays and CT scans are common in the ED. In 2010, slightly more than 47% of all ED visits in the United States had an imaging exam associated with them.
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 this latest report.
In the new study, researchers 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. The overall rate of imaging utilization in the Massachusetts General ED was 45.4% in 2011, similar to the 2010 national average of 47.2%. Analysis of the data revealed that physician-related factors like gender, experience, and training did not correlate with imaging use. 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.
