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Area of Science:

  • Emergency Medicine
  • Radiology
  • Health Services Research

Background:

  • Diagnostic imaging is frequently utilized in emergency departments.
  • Understanding imaging patterns in observation units versus inpatient admissions is crucial for resource allocation and cost-effectiveness.

Purpose of the Study:

  • To compare the utilization of diagnostic imaging in emergency department (ED) observation units versus patients admitted to inpatient services from the ED.
  • To identify differences in imaging modalities used between these two patient groups.

Main Methods:

  • Retrospective, descriptive analysis of electronic medical records.
  • Random selection of 105 ED observation patients and 108 inpatient admissions from February 2014.
  • Review of diagnoses and types/quantities of imaging tests obtained.

Main Results:

  • Overall imaging use was similar between ED observation patients (76%) and inpatients (79%).
  • ED observation patients were more likely to undergo Magnetic Resonance Imaging (MRI) (P=.0243).
  • Common diagnoses for ED observation included neurologic complaints (25%), abdominal pain (17%), and cardiac symptoms (16%).

Conclusions:

  • There is no significant difference in the overall diagnostic imaging use between ED observation and directly admitted inpatient patients.
  • The higher proportion of healthcare costs borne by ED observation patients suggests a substantive impact of imaging utilization in this group.