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Variation in Patients' Travel Times among Imaging Examination Types at a Large Academic Health System
Andrew B Rosenkrantz1, Yu Liang2, Richard Duszak3
1Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, New York, NY 10016.
Rationale And Objectives:
Patients' willingness to travel farther distances for certain imaging services may reflect their perceptions of the degree of differentiation of such services. We compare patients' travel times for a range of imaging examinations performed across a large academic health system.
Materials And Methods:
We searched the NYU Langone Medical Center Enterprise Data Warehouse to identify 442,990 adult outpatient imaging examinations performed over a recent 3.5-year period. Geocoding software was used to estimate typical driving times from patients' residences to imaging facilities. Variation in travel times was assessed among examination types.
Results:
The mean expected travel time was 29.2 ± 20.6 minutes, but this varied significantly (p < 0.001) among examination types. By modality, travel times were shortest for ultrasound (26.8 ± 18.9) and longest for positron emission tomography-computed tomography (31.9 ± 21.5). For magnetic resonance imaging, travel times were shortest for musculoskeletal extremity (26.4 ± 19.2) and spine (28.6 ± 21.0) examinations and longest for prostate (35.9 ± 25.6) and breast (32.4 ± 22.3) examinations. For computed tomography, travel times were shortest for a range of screening examinations [colonography (25.5 ± 20.8), coronary artery calcium scoring (26.1 ± 19.2), and lung cancer screening (26.4 ± 14.9)] and longest for angiography (32.0 ± 22.6). For ultrasound, travel times were shortest for aortic aneurysm screening (22.3 ± 18.4) and longest for breast (30.1 ± 19.2) examinations. Overall, men (29.9 ± 21.6) had longer (p < 0.001) travel times than women (27.8 ± 20.3); this difference persisted for each modality individually (p ≤ 0.006).
Conclusions:
Patients' willingness to travel longer times for certain imaging examination types (particularly breast and prostate imaging) supports the role of specialized services in combating potential commoditization of imaging services. Disparities in travel times by gender warrant further investigation.