Imaging Among the Underserved: Utilization and Expenditures in a Student-Run Free Clinic

To determine imaging utilization and expenditures among an underserved population at a student-run free clinic.

This was a retrospective review of billing records for all radiology studies performed over a 4-year period at a student-run free clinic supervised by physician faculty. All imaging services were outsourced through either direct payment by the clinic to a local imaging group or through in-kind donations. Radiology studies were grouped by modality and diagnostic category. Data were analyzed to determine overall and average imaging utilization and expenditures.

Across the 4-year study period, 413 radiology studies were performed with a yearly average of 103 (SD = 16). During this time, 192 (46%) ultrasounds, 123 (30%) radiographic studies, 40 (10%) MRIs, 37 (9%) CTs, 8 (2%) interventional procedures, and 5 (1%) nuclear imaging studies were obtained. Overall, expenditures were $157,888 with a yearly average of $39,472 (SD = $1982). In-kind donations accounted for $138,508 (88%) of expenditures. Across the 4-year study period, utilization increased by 15% with less than 1% increase in expenditures.

Ultrasound was the most common imaging modality used. Overall imaging utilization was considerably less than that of published data in an ambulatory setting.