Determinants of diagnostic imaging utilization in primary care

Area of Science:

• Health Services Research
• Medical Informatics
• Primary Care Medicine

Background:

• Diagnostic imaging utilization in primary care is influenced by various factors.
• Understanding these determinants is crucial for optimizing resource allocation and patient care.

Purpose of the Study:

• To investigate patient and physician factors associated with diagnostic imaging utilization in primary care settings.
• To identify key variables influencing the ordering and intensity of outpatient imaging exams.

Main Methods:

• Retrospective cohort study of 85,277 patients and 148 primary care physicians (PCPs) from July 2007 to June 2009.
• Data extracted from electronic medical records and administrative databases.
• Analysis of 17 patient factors (clinical need, demographics) and 7 physician factors on imaging exam orders.

Main Results:

• Significant patient factors included race, medication count, congestive heart failure, diabetes, hypertension, other conditions, PCP visits, specialist visits, and prior specialist imaging orders.
• Significant physician factors included experience, gender, and additional degrees.
• These factors influenced both the probability of ordering imaging and the number of exams ordered.

Conclusions:

• Both patient-specific characteristics and physician attributes substantially affect the utilization of diagnostic imaging in primary care.
• These factors play a critical role in determining whether imaging is ordered and the volume of imaging performed.