Variation in Computerized Tomography Scan Utilization

Abstract

The U.S. health care system is one of the most expensive health care systems in the world, yet it is not as efficient as it is expected. Studies have shown that the use of expensive imaging procedures, such as CT scans, was significantly increasing for the past few years. However, the increased number of CT scans may not help to improve quality of care. No studies are conducted on investigate geographic variation on CT scan usage rate. This research is the first one to examine CT scan usage rate among counties and to examine variation caused by patient and hospital characteristics. We used the 2007 HCUP-SID database provided data for the research. GIS graph was used to illustrate geographic variation on CT scan usage in New York State. Contingency tables were developed to evaluate to what extent patient and hospital characteristics contribute to the variation. A logistic regression model was built to control the variation caused by patient and hospital characteristics in order to find variation contributed by other potential factors such as availability of CT scanners and radiologists. Significant geographic variation of CT scan usage rate in the county level of New York State was found. Patient demographics, insurance status and medical conditions as well as hospital bed size and teaching status were contributing factors to the variation. After controlling these factors, significant geographic variation was still found. It indicates that other potential reasons would influence the technology use.