In determining the level of use of healthcare imaging resources, research published this week in JAMA Oncology found that regional factors are of high importance. Being able to better understand those patterns, the study's authors said, could help make better use of healthcare programs.
The researchers aimed to see if a correlation existed between regional rates of inappropriate screening for breast cancer and prostate cancer. For their study, they used a Medicare database and examined data for about 9,000 male Medicare beneficiaries with low-risk prostate cancer, as well as 30,000 female beneficiaries with low-risk breast cancer.
They found that the percentages of patients who received inappropriate imaging for prostate cancer (44.4 percent) were very similar to the percentages who were inappropriately scanned for breast cancer (41.8 percent). In addition, a man with low-risk prostate cancer was more likely to undergo inappropriate imaging if he lived in a hospital referral region with higher inappropriate breast cancer imaging. The study's authors also found a correlation between use of CT scans and bone scans for cancer patients within hospital referral regions.
Interestingly, they also found that breast cancer imaging rates correlated with prostate cancer screening rates more strongly than the other way around.
"As patients with prostate cancer and breast cancer are a nonoverlapping cohort treated by nonoverlapping specialists, an association of inappropriate imaging between them suggests that regional culture and infrastructure contribute to healthcare utilization patterns across diseases," the study's authors said.
They add that because of the findings, inappropriate imaging must be addressed, in part, through influencing local health system factors that are contributing to the inappropriate imaging. This can be done through policy changes to improve care quality and lower costs.
Research published earlier this year in the American Journal of Managed Care found that providers who participate in a health information exchange (HIE) are less likely to order duplicative imaging tests. The researchers, from Weill Cornell Medical College and elsewhere, evaluated the Rochester, New York-based Regional Health Information Organization (RHIO), an HIE serving an 11-county community, to determine if HIE use affected the number of repeating imagings. They reviewed 2009-2010 data from two commercial health plans representing more than half of insured patients, who consented to the data sharing.
A survey of hospital executives in September found that the U.S. healthcare system spends at least $7.47 billion, and as much as $11.95 billion on unnecessary imaging every year.
To learn more:
- check out the study