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Open Access Research article

Socio-economic variation in CT scanning in Northern England, 1990-2002

Mark S Pearce1*, Jane A Salotti1, Kieran McHugh2, Kwang Pyo Kim3, Alan W Craft4, Jay Lubin5, Elaine Ron6 and Louise Parker78

Author Affiliations

1 Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK

2 Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, UK

3 Department of Nuclear Engineering, Kyung Hee University, Gyeonggi-Do, Republic of Korea

4 Northern Institute of Cancer Research, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK

5 Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Bethesda, Maryland, 20892, USA

6 Deceased

7 Department of Medicine and Paediatrics, Population Cancer Research Program, Dalhousie University, Halifax, Nova Scotia, Canada

8 Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada

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BMC Health Services Research 2012, 12:24  doi:10.1186/1472-6963-12-24

Published: 27 January 2012

Abstract

Background

Socio-economic status is known to influence health throughout life. In childhood, studies have shown increased injury rates in more deprived settings. Socio-economic status may therefore be related to rates of certain medical procedures, such as computed tomography (CT) scans. This study aimed to assess socio-economic variation among young people having CT scans in Northern England between 1990 and 2002 inclusive.

Methods

Electronic data were obtained from Radiology Information Systems of all nine National Health Service hospital Trusts in the region. CT scan data, including sex, date of scan, age at scan, number and type of scans were assessed in relation to quintiles of Townsend deprivation scores, obtained from linkage of postcodes with census data, using χ2 tests and Spearman rank correlations.

Results

During the study period, 39,676 scans were recorded on 21,089 patients, with 38,007 scans and 19,485 patients (11344 male and 8132 female) linkable to Townsend scores. The overall distributions of both scans and patients by quintile of Townsend deprivation scores were significantly different to the distributions of Townsend scores from the census wards included in the study (p < 0.0001). There was a significant association between type of scan and deprivation quintile (p < 0.0001), primarily due to the higher proportions of head scans in the three most deprived quintiles, and slightly higher proportions of chest scans and abdomen and pelvis scans in the least deprived groups. There was also a significant association (p < 0.0001) between the patient's age at the time of the CT scan and Townsend deprivation quintiles, with slightly increasing proportions of younger children with increasing deprivation. A similar association with age (p < 0.0001) was seen when restricting the data to include only the first scan of each patient. The number of scans per patient was also associated with Townsend deprivation quintiles (p = 0.014).

Conclusions

Social inequalities exist in the numbers of young people undergoing CT scans with those from deprived areas more likely to do so. This may reflect the rates of injuries in these individuals and implies that certain groups within the population may receive higher radiation doses than others due to medical procedures.