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Trends in CT Request and Related Outcomes in a Pediatric Emergency Department
S M Saiful Islam1, Amir Fattah Abru1, Saeed Al Obaidani1
1Department of Pediatric Emergency Medicine, Royal Hospital, Muscat, Oman.
Insights
Computed tomography (CT) use in pediatric emergency departments increased significantly from 2010-2014, outpacing patient visit growth. This trend led to higher costs and longer wait times for pediatric CT scans.
Area of Science:
- Radiology and Imaging
- Pediatric Emergency Medicine
- Healthcare Management
Background:
- Computed tomography (CT) is a vital diagnostic tool in pediatric emergency care.
- Understanding trends in CT utilization is crucial for resource allocation and patient management.
- Previous studies have highlighted variations in CT use across different pediatric populations and healthcare settings.
Purpose of the Study:
- To analyze the trends in computed tomography (CT) utilization within a pediatric emergency department (PED) from 2010 to 2014.
- To assess the associated changes in diagnostic imaging costs and patient waiting times.
- To identify specific anatomical areas driving the increase in CT scan requests.
Main Methods:
- Retrospective analysis of electronic medical records for pediatric patients (birth to 12 years) visiting the PED.
- Data collection on the number and types of CT scans requested (head, abdomen/pelvis, chest, cervical spine/neck) between January 2010 and December 2014.
- Calculation of CT utilization rates per 1000 visits and analysis of cost implications.
Main Results:
- CT scans increased from 7 to 12 per 1000 PED visits between 2010 and 2014, a 71% rise.
- CT requests surged by 56% (87 to 175), while pediatric emergency visits grew by 28% (11,721 to 15,052).
- Cervical spine CT scans showed the highest increase (600%), followed by chest (112%) and head (54%); costs doubled, increasing average PED costs by $2 per visit.
Conclusions:
- CT utilization in the pediatric emergency department has risen disproportionately compared to the growth in patient volume.
- This increased demand for diagnostic imaging is linked to escalating healthcare costs and extended patient waiting times.
- The findings underscore the need for careful evaluation of CT ordering practices in pediatric emergency settings to optimize resource use and patient care.
Objectives:
To study and to establish the overall trends of computed tomography (CT) use and associated outcomes in the pediatric emergency department (PED) at Royal Hospital, Oman, from 2010 to 2014.
Methods:
The hospital electronic medical record was retrospectively searched to find children (from birth to 12 years old) who had visited the PED and the number of CT requests between 1 January 2010 and 31 December 2014. The types of CT examinations ordered were analyzed according to anatomical location and were as follows; head, abdomen/pelvis, chest, cervical spine/neck, and others.
Results:
There were a total of 67 244 PED visits during the study period, 569 of which received 642 CT scans. There was a remarkable rise in CT uses per 1000 visits from 7 in 2010 to 12 in 2014. There was a 56% hike in CT requests from 87 in 2010 to 175 in 2014 while the number of pediatric emergency visits rose by about 28% from 11 721 to 15 052. Although head CT scans were the most common, cervical spine CT scans had the highest rate of increase (600%) followed by the chest (112%), head (54%) and abdomen (13%). There were no significant changes in other CT scan requests. The cost of CT scans increased from $18 096 to $36 400 during the study period, which increased the average PED cost by about $2 per visit. The average time between a CT being requested and then performed was 1.24 hours.
Conclusions:
CT use in the pediatric emergency department has risen significantly at a rate that markedly exceeds the growth of emergency visits. This is associated with an increase in PED costs and longer waiting times.
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