CT Utilization: A Case Study in Iran based on ACR Appropriateness Criteria

Area of Science:

• Radiology and Imaging
• Healthcare Management
• Medical Economics

Background:

• Controlling healthcare costs and ensuring appropriate utilization of medical imaging are critical.
• Computed tomography (CT) scans represent a significant portion of imaging expenditures.
• Assessing CT scan utilization against established appropriateness criteria is essential for quality improvement.

Purpose of the Study:

• To evaluate the utilization of CT scans based on the American College of Radiology (ACR) appropriateness criteria.
• To identify the rates of appropriate, may be appropriate, and inappropriate CT scan procedures.
• To provide recommendations for improving CT scan utilization at Kashan University of Medical Sciences Tertiary Care University Hospital (KAUMS-TCUH).

Main Methods:

• Retrospective analysis of CT scan procedures performed at KAUMS-TCUH.
• Classification of CT scan utilization according to ACR appropriateness criteria.
• Analysis of utilization rates across different patient conditions, focusing on trauma and ataxia.

Main Results:

• Appropriate CT scan utilization was 78.9%, with 9.1% inappropriate and 11.9% may be appropriate.
• Trauma patients had the highest rates for both appropriate (101 cases, 87.8%) and inappropriate (8 cases, 34.8%) CT scan requests.
• A significant portion of CT scans fell into the inappropriate or may be appropriate categories, suggesting suboptimal utilization.

Conclusions:

• CT scan utilization at KAUMS-TCUH is not optimal, with a notable percentage of scans being inappropriate or questionable.
• Immediate interventions are required to reduce the rates of inappropriate and potentially unnecessary CT scans.
• Establishing a utilization committee for resources is recommended to regularly direct and improve CT scan utilization.