National fluid shifts: fifteen-year trends in paracentesis and thoracentesis procedures.

J Am Coll Radiol. 2010 Nov;7(11):859-64

Authors: Duszak R, Chatterjee AR, Schneider DA

The aim of this study was to evaluate national trends in paracentesis and thoracentesis procedures and the relative roles of specialty groups providing these services.

PMID: 21040867 [PubMed - indexed for MEDLINE]

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Inpatient CT and MRI Utilization: Trends in the Academic Hospital Setting.

J Am Coll Radiol. 2010 Dec;7(12):949-55

Authors: Agarwal R, Bergey M, Sonnad S, Butowsky H, Bhargavan M, Bleshman MH

PURPOSE: The aim of this study was to determine trends in the utilization of inpatient CT and MRI at academic medical centers. METHODS: Surveys requesting inpatient CT volumes, inpatient MRI volumes, discharges excluding newborns, and case-adjusted mix index from 2002 to 2007 were e-mailed to all 123 members of the Society of Chairmen of Academic Radiology Departments. CT and MRI studies per discharge were adjusted using the case mix index (CMI) provided by each hospital to adjust for the differences in patient mix at participating institutions. Trends in adjusted inpatient imaging utilization were compared over time and across responding institutions. RESULTS: Twenty-two of 123 chairs (17.9%) of academic radiology departments, representing all geographic regions and a wide variability in National Institutes of Health research funding ranking, provided responses to our survey. Between 2002 and 2007, there was an increase in median CMI-adjusted CT studies per discharge of 28.0% and an increase in median CMI-adjusted MRI studies per discharge of 19.8%. The largest annual percentage increase in CT utilization (20.2%) occurred from 2003 to 2004, and there was negative growth between 2006 and 2007 of -3.74%. The largest annual percentage increase in MRI utilization (13.9%) occurred from 2006 to 2007, with 3 years of negative growth from 2002 to 2003, 2004 to 2005, and 2005 to 2006. In 2007, there was a wide range in CMI-adjusted CT studies per discharge between institutions from 0.16 to 0.75, with a mean of 0.40 ± 0.18, with a corresponding wide range in CMI-adjusted MRI studies per discharge of 0.04 to 0.16, with a mean of 0.09 ± 0.03. CONCLUSION: There has been large growth in inpatient CT and MRI utilization at academic medical centers. This growth is variable over time and between institutions. Practice leaders can use this information to compare themselves with their peers and to monitor the impact of programmatic improvements on inpatient imaging utilization and in discussions with health system leaders who would like to improve system profitability by decreasing costly inpatient imaging procedures.

PMID: 21129686 [PubMed - in process]

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Related Articles

Patients imaged early during admission demonstrate reduced length of hospital stay: a retrospective cohort study of patients undergoing cross-sectional imaging.

J Am Coll Radiol. 2010 Apr;7(4):269-76

Authors: Batlle JC, Hahn PF, Thrall JH, Lee SI

PURPOSE: The aim of this study was to relate the early use of advanced imaging to length of hospital stay. MATERIALS AND METHODS: Among all 33,226 admissions to an urban tertiary care hospital in 2005, the authors identified the 10,005 admissions (30.1%) that included >or=1 advanced imaging study (CT, MRI, or nuclear scintigraphy) during the period from 1 day before admission (day -1) through discharge. The length of stay was calculated, and using the date of the first advanced imaging study performed relative to date of admission (date of service), the residual length of stay (length of stay minus date of service) of each admission was also calculated. For admissions of >or=3 days in duration, the mean length of stay of patients with early imaging (on day -1 or 0) was compared using t test to that of patients with later imaging (on day 1 or 2). For all admissions with advanced imaging, linear regression analysis was applied to length of stay and residual length of stay as a function of date of service. Similar analysis was performed on subgroups classified by examination type (modality and body part) and International Classification of Diseases, Ninth Revision (ICD-9) diagnostic code. RESULTS: The mean length of stay was significantly shorter for those imaged on day -1 or 0 compared with day 1 or 2 for all admissions of >or=3 days (8.6 vs 9.0 days, P = .015) and for the following specific subgroups: abdominal CT (8.4 vs 9.7 days, P = .003) and neurologic MR examination types (7.6 vs 8.7 days, P = .03) and abdominal ICD-9 codes (7.5 vs 8.8 days, P = .007). A statistically significant positive correlation was noted between length of stay and date of service for all admissions (slope, 0.27; P < .001) and for the following subgroups: neurologic CT, chest CT, abdominal CT, and nuclear scintigraphy examination types and abdominal ICD-9 codes. CONCLUSION: Early imaging with CT, MRI, or nuclear scintigraphy, particularly on the day before or the day of admission, was associated with significantly shorter lengths of stay of inpatients compared with patients who underwent advanced imaging later.

PMID: 20362942 [PubMed - indexed for MEDLINE]

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