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Access to primary care and computed tomography use in the emergency department
Access to primary care and computed tomography use in the emergency department
- Source :
- BMC Health Services Research, Vol 18, Iss 1, Pp 1-10 (2018), BMC Health Services Research
- Publication Year :
- 2018
- Publisher :
- BMC, 2018.
-
Abstract
- Background The decision to obtain a computed tomography CT scan in the emergency department (ED) is complex, including a consideration of the risk posed by the test itself weighed against the importance of obtaining the result. In patients with limited access to primary care follow up the consequences of not making a diagnosis may be greater than for patients with ready access to primary care, impacting diagnostic reasoning. We set out to determine if there is an association between CT utilization in the ED and patient access to primary care. Methods We performed a cross-sectional study of all ED visits in which a CT scan was obtained between 2003 and 2012 at an academic, tertiary-care center. Data were abstracted from the electronic medical record and administrative databases and included type of CT obtained, demographics, comorbidities, and access to a local primary care provider (PCP). CT utilization rates were determined per 1000 patients. Results A total of 595,895 ED visits, including 98,001 visits in which a CT was obtained (16.4%) were included. Patients with an assigned PCP accounted for 55% of all visits. Overall, CT use per 1000 ED visits increased from 142.0 in 2003 to 169.2 in 2012 (p
- Subjects :
- Adult
Male
medicine.medical_specialty
Demographics
Adolescent
Computed tomography
Primary care
Health Services Accessibility
030218 nuclear medicine & medical imaging
Health administration
Limited access
Multidetector computed tomography
03 medical and health sciences
Young Adult
0302 clinical medicine
medicine
Humans
Electronic health records
In patient
Aged
Aged, 80 and over
medicine.diagnostic_test
Primary Health Care
business.industry
Health Policy
lcsh:Public aspects of medicine
030208 emergency & critical care medicine
lcsh:RA1-1270
Emergency department
Middle Aged
Health services
Radiation exposure
Cross-Sectional Studies
Emergency medicine
Diagnostic imaging
Female
Health Services Research
business
Emergency Service, Hospital
Tomography, X-Ray Computed
Emergency service
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....ca2c0a2322886aba63799552c9f1a9ea
- Full Text :
- https://doi.org/10.1186/s12913-018-2958-4