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Radiologic consultation: effect on inpatient diagnostic imaging evaluation in a teaching hospital
R H Gottlieb1, G M Hollenberg, P J Fultz
1Department of Radiology, University of Rochester School of Medicine and Dentistry, NY 14642, USA.
Academic Radiology
|March 1, 1997
Summary
Radiologic consultation reviewing expensive imaging study requests did not significantly alter resident physician ordering habits. The study found no significant change in the use of costly imaging tests despite radiologist review.
Area of Science:
- Radiology
- Medical Education
- Health Services Research
Background:
- Resident physicians frequently order imaging studies.
- The cost-effectiveness of some imaging studies is a concern.
- Radiologist input may influence resident ordering practices.
Purpose of the Study:
- To evaluate the impact of radiologic consultation on resident physician ordering of expensive imaging studies.
- To determine if routine radiologist review of requisitions affects the utilization of costly imaging.
Main Methods:
- A prospective evaluation of 180 requisitions for expensive imaging studies across three general medicine floors.
- Two floors received radiologic consultation on inappropriate or undecided requisitions before study performance.
- One control floor did not receive this consultation.
Main Results:
- 7.6% of requisitions on consultation floors were deemed inappropriate.
- Radiologist interaction modified imaging evaluation in 2.5% of cases.
- No significant difference was observed in the total number or proportion of expensive imaging studies between consultation and control floors.
Conclusions:
- Routine radiologic consultation on expensive imaging study requisitions did not significantly impact house staff ordering patterns.
- The current system of radiologist review of requisitions may not be an effective strategy for controlling the use of expensive imaging.