Hospitals are overusing double CT scans, risking patient harm, CMS finds

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As imaging testing ranks as one of the fastest growing procedures, hundreds of hospitals may be needlessly irradiating patients by overusing double CT scans, according early data released from the Centers for Medicare & Medicare (CMS), reports Kaiser Health News and The Washington Post.

A double CT scan is two scans in succession that many physicians argue should be rarely used. A single CT chest scan is essentially equal to 350 standard chest X-rays, according to The Boston Globe. Medicare does not regulate the use of double scans, according to The Washington Post.

In addition to exposing patients to radiation, the excess in CT scans racks up healthcare costs for patients and Medicare. Medicare paid hospitals $25 million for double scans in 2008, according to The Boston Globe.

More than 200 hospitals use double CT scans on more than 30 percent of their Medicare outpatients; the U.S. average is 5.4 percent.

For example, Memorial Medical Center of West Michigan in Ludington had the highest rate in the nation. It ran 89 percent of its Medicare chest CT patients through both scans in 2008, a rate that lowered to 42 percent last year, according to The Washington Post.

Users of the double CT scan argue that the extra scan provides more medical information, providing better patient care. In addition, physicians--some of whom are practicing outside the hospital--may add on more tests for fear of malpractice.

Even though Medicare does not regulate use of double scans, hospitals can monitor and control its use.

"Hospitals will say, ‘Wait, we don't order tests, why are you measuring us?' '' said Dr. Michael Rapp, who directs the Quality Measurement and Health Assessment Group in The Boston Globe article. But, he added, "Hospitals certainly have the ability to put in policies and to monitor what's happening.''

The full CMS report is expected to be released next month.

For more:
- read The Washington Post article
- check out the Kaiser map of scan rates in the country
- read The Boston Globe article

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