Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study.
BMJ Open
; 6(6): e010973, 2016 06 08.
Article
em En
| MEDLINE
| ID: mdl-27279477
ABSTRACT
OBJECTIVES:
To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition.SETTING:
A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan.PARTICIPANTS:
Adult ED visits (aged ≥18â years) during 2009-2013, with or without receiving CT, were enrolled as the study participants. MAIN OUTCOMEMEASURES:
For all enrolled ED visits, we retrospectively analysed (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay.RESULTS:
In all, 269â 239 adult ED visits (148â 613 male patients and 120â 626 female patients) were collected during the 5-year study period, comprising 38â 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013).CONCLUSIONS:
ED CT utilisation rates increased significantly during 2009-2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Triagem
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Serviço Hospitalar de Emergência
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2016
Tipo de documento:
Article