Radiology referrals patterns in a free clinic setting

Area of Science:

• Radiology and Medical Imaging
• Public Health
• Healthcare Access

Background:

• Underserved populations face significant barriers to accessing timely medical imaging.
• Free clinics play a crucial role in providing healthcare to vulnerable patient groups.
• Understanding imaging referral completion is vital for ensuring equitable care.

Purpose of the Study:

• To evaluate the completion rates of imaging referrals from an urban free clinic.
• To identify patient and imaging-specific factors associated with referral completion.
• To assess the impact of different imaging service delivery models on completion rates.

Main Methods:

• Retrospective analysis of 882 imaging referral orders from January 2017 to December 2022.
• Study conducted at a single urban, outpatient, free clinic.
• Compared completion rates for on-site (POCUS, mobile mammography) versus off-site imaging services.

Main Results:

• Overall imaging referral completion rate was 48% (424/882).
• Ultrasound had the highest completion rate (59%), followed by X-rays (45%) and mammography (37%).
• On-site services achieved a 77% success rate, significantly higher than off-site services (p < 0.0001).
• Referrals for patients with unknown race/ethnicity or language preference had lower completion rates (p < 0.0001).

Conclusions:

• Low imaging referral completion rates highlight challenges in providing consistent care to underserved populations.
• Mobile and point-of-care imaging services demonstrate significant potential to improve access and completion.
• Further interventions are needed to optimize imaging care pathways for free clinic patients.