By several measures, health care spending continues to rise, forcing businesses and families to cut back on operations and household expenses. In 2008, health care spending in the United States reached $2.4 trillion dollars, and is projected to reach $3.1 trillion in 2012.During the past decades, there has been a steady increase in the utilization of expensive inpatient imaging studies, with an overall increase in health care costs. In particular, advanced imaging includes CT, MRI and Nuclear Medicine, used for the diagnosis and management of hospitalized patients. The reasons for unnecessary imaging examinations include indirect financial benefit to physicians, medico-legal considerations, lack of accepted guidelines or failure to follow established ones. In the United States alone, it is estimated that CT testing accounts for around 6,000 additional cancers per year, with about half of those proving fatal. Each radiologic study using gadolinium presented a 2.4% risk of developing nephrogenic systemic fibrosis, with significant morbidity and mortality. We have shown that education of the ordering physicians is a feasible and cost effective means to decrease the over-otilization of advanced imaging in the inpatient setting.
Madero G., Platnick J, Voutsinas L, Wetz R, Buchbinder, S. “Over-utilization of advanced imaging in the hospital setting: An educational approach to reduce unnecessary inpatient studies.” Poster session presented at: ACP National Abstracts Competition; 2009 April 23-25, Philadelphia, PA.