Journal scan

Patients without primary care providers more likely to have CT scan in emergency departments, study finds

American-based research finds more people who have CT scans in the emergency department didn't have a primary care provider

Patients are more likely to have a computed tomography (CT) scan in an emergency department (ED) if they don’t have access to a primary care provider, research has found.

A computed tomography beign carried out. Picture: iStock

The study, carried out at Saint Mary’s Hospital Campus Mayo Clinic in Minnesota, America, analysed all ED visits where a CT scan was obtained between 2003 and 2012. A total of 595,895 visits, including 98,001 visits where a CT was obtained (16.4%), were included.

CT use per 1,000 ED visits increased at 21.5% from 169.4 to 205.8 over the study period for patients without a primary care provider. For patients with a primary care provider, there was a 19.4% increase from 118.9 to 142.

Ethnicity divide

The study found that more caucasian patients had a CT scan compared to other ethnicities (17.1% white, 13.9% Asian, 12.5% Hispanic, 10.6% African American).

Overall, there was a 19.2% increase in CT scans over the study period from 142 per 1000 ED visits in 2003 to 169.2 in 2012. The number of ED visits during this time remained relatively stable.

The authors concluded that increasing access to primary care, particularly for follow-up from the ED, could reduce CT use, lowering costs, length of stay in the ED and radiation exposure.

However, they acknowledged that because it was conducted in one single ED the results may not be generalised to other populations.

Bellolio MF, Bellew SD, Sangaralingham LR et al (2018) Access to primary care and computed tomography use in the emergency department. BMC Health Services Research.

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