Managed reduction of unnecessary skull radiography

A program to reduce unnecessary skull radiography for trauma was instituted in a teaching hospital in 1970 and eventually proved successful. In 1970, 2 976 skull examinations were made for all purposes and this fell to 791 examinations in 1983. A similar reduction occurred concurrently in the other university teaching hospital departments without the formal program. Only recently has this trend begun in urban hospitals and there is still no change in rural hospitals and urban private radiology offices. The reasons for the decline are attempts to moderate radiation dose, cost containment, clinical use of high yield criteria, and early employment of computed tomography head scanning for trauma. The savings in skull radiography match the related costs of computed tomography with improved patient care.