Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study
1 Helse Sør-Øst Health Services Research Centre Akershus University Hospital Sykehusveien 27, NO-1478 Lørenskog, Norway
2 Centre for Diagnostic Imaging Akershus University Hospital Sykehusveien 27, NO-1478 Lørenskog, Norway
3 Department of Community and Family Medicine Duke University Medical Center 318 Hanes House, DUMC 2914 2914 Durham, NC 27710 USA
4 Duke-NUS Graduate Medical School Singapore 2 Jalan Bukit Merah 169547, Singapore
5 Faculty Division Akershus University Hospital University of Oslo Forskningsveien 3 A, NO-0316 Oslo, Norway
BMC Health Services Research 2010, 10:262 doi:10.1186/1472-6963-10-262Published: 6 September 2010
One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS).
Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups.
There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence.
Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.