找出减少住院儿童成像过度使用的机会
Sanyukta Desai1,2, Jennifer Treasure3,4, Troy Richardson5
1Division of Hospital Medicine, Dell Children's Medical Center, Austin, Texas, USA.
Journal of hospital medicine
|December 2, 2024
概括
为了减少住院儿童的成像过度使用,需要针对频繁使用,高成本和医院显著变化的条件. 本研究确定了改善儿科成像实践的关键领域,并减少相关的危害和费用.
科学领域:
- 儿科放射学 儿科放射学
- 改善医疗保健质量 改善医疗保健质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 放射性成像是诊断住院儿童的标准.
- 影像实践的变化可能会导致损害和成本的增加.
- 优化成像使用对于改善儿科医疗保健至关重要.
研究的目的:
- 确定常见的儿科住院病症,成像患病率高.
- 分析各医院成像实践和相关成本的变化.
- 针对儿科成像的有针对性的质量改进举措的精确区域.
主要方法:
- 在50个儿童医院 (2017-2019) 中对儿童 (0-18岁) 进行横截面研究.
- 包括≥2500次放电和≥30%成像使用的条件.
- 分析了成像频率,标准化成本和医院级变化 (ICC).
主要成果:
- 最常见的成像是胸部挖掘 (97.8%),脊椎病 (96.2%),肠道阻塞 (96%).
- 骨折 (21.4M美元),创伤 (15.7M美元),尾炎 (8.6M美元) 的总成本最高.
- 脊椎病 (ICC=0.49) 和前皮细胞炎 (ICC=0.48) 的成本变化最多.
结论:
- 优先考虑频繁成像,高成本和高变化的条件进行改进.
- 专注于证据生成和指导方针开发,以减少成像过度使用.
- 针对这些领域的倡议可以提高儿科护理的质量和效率.
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