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Contemporary trends in utilization of pediatric cardiac imaging in children's hospitals
Karina Javalkar1, Yuanyuan Fu2, Stuart Lipsitz1
1Department of Cardiology, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Insights
Pediatric cardiac imaging shows a significant rise in computed tomography (CT) and magnetic resonance (MR) use. Echocardiography use declined, while CT and MR utilization surged, with regional variations noted.
Area of Science:
- Pediatric Cardiology
- Medical Imaging Technology
- Healthcare Utilization Trends
Background:
- Increasing availability and use of cardiac CT (CCT) and cardiac MR (CMR) in pediatric cardiology.
- Need for data on utilization trends to define appropriate use and guide resource allocation.
Purpose of the Study:
- To analyze trends in the utilization of cardiac imaging modalities in pediatric cardiology.
- To understand the changes in the proportion of echocardiography, CCT, and CMR use over time.
Main Methods:
- Retrospective observational study using the Pediatric Health Information Systems (PHIS) database (2010-2023).
- Included hospital encounters with codes for echocardiography, CCT, or CMR.
- Calculated the annual proportion of encounters for each imaging test; primary outcome was the change in proportion.
Main Results:
- Total cardiac imaging encounters increased; echocardiography proportion decreased by 6.5%.
- Cardiac CT (CCT) and cardiac MR (CMR) proportions increased significantly (200% and 70%, respectively).
- Observed variations in imaging utilization based on geographic region and patient diagnosis.
Conclusions:
- Marked increase in CCT use in pediatric cardiac imaging, with significant regional utilization disparities.
- Growing role of CCT necessitates tailored training for pediatric cardiologists and increased resource allocation.
- Future research should investigate drivers of regional variation and the impact of modality choice on patient outcomes.
Background:
There has been an increase in availability and utilization of cardiac CT (CCT) and magnetic resonance (CMR) imaging in pediatric cardiology. Understanding trends in their utilization can provide foundational data for defining appropriate use of these tests in pediatrics, and guide resource distribution enhance access to these modalities.
Methods:
This retrospective observational study utilized data from the Pediatric Health Information Systems (PHIS) database, a clinical and billing database including 49 children's hospitals. Encounters between 2010 and 2023 that had a code for any cardiac imaging test (echocardiography, CCT, or CMR) were included. The proportion of encounters utilizing each cardiac imaging test per year was calculated, and the primary outcome was the change in this proportion.
Results:
A total of 95,021,317 hospital-based encounters were queried, of which 1,442,094 had at least one of the 3 tests performed. The total number of encounters utilizing any cardiac imaging test increased over the study period. The proportion of encounters with echocardiography decreased (by 6.5 %) while those with CMR and CCT increased (70 % and 200 % respectively) over the study period. There was variation in imaging utilization by geographic region and diagnosis.
Conclusion:
This study highlights a marked increase in CCT use in pediatric cardiac imaging, accompanied by regional disparities in utilization. The growing role of CCT underscores the need for tailored training programs for pediatric cardiologists and increased resource allocation to meet rising demand. Future research should explore the drivers of regional variation and investigate the impact of modality choice on patient outcomes and care efficiency.
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