Garry Nixon1, Ari Samaranayaka2, Brandon de Graaf2, Roz McKechnie1, Peter Rodwell3, Katharina Blattner1. 1. Dunedin School of Medicine, University of Otago, Dunedin. 2. Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin. 3. Department of Emergency Medicine, Oamaru Hospital, Otago, New Zealand.
Abstract
OBJECTIVE: In 2008, Oamaru Hospital became the second rural hospital in New Zealand to install a computed tomography (CT) scanner. This article assesses the impact of this on local CT scanning rates. DESIGN: Observational: review of radiology department data. SETTING: Rural hospital imaging services. PARTICIPANTS: CT scanning patients residing in Otago region during the study period. INTERVENTIONS: There is no intervention in this observational study. MAIN OUTCOME MEASURES: CT scanning rates and waiting times before and after the introduction of the rural scanner. RESULTS: Prior to the scanner being commissioned, there was a significant urban versus rural disparity in CT utilisation. Residents in the neighbouring urban centre were 1.4 times more likely to access CT (33.2 (95% confidence interval (CI) 32.2-34.2) versus 23.0 (95% CI 21.0-25.1) scans per 1000 residents per annum). Twenty months after the scanner was commissioned, the rate for the rural community had almost doubled to 45.6 (95% CI 43.0-48.2) and was 1.2 times greater than for the urban community. This difference was not sustained, and rural and urban communities had similar CT scanning rates in 2011 and 2012. Mean waiting time for residents in the rural community fell from 21.1 (95% CI 17.1-25.2) days prior to the scanner to 6.7 (95% CI 5.6-7.8) days after the scanner was commissioned. CONCLUSIONS: On-site CT increased the rural scanning rate, corrected the rural-urban disparity and reduced waiting times without apparent over servicing.
OBJECTIVE: In 2008, Oamaru Hospital became the second rural hospital in New Zealand to install a computed tomography (CT) scanner. This article assesses the impact of this on local CT scanning rates. DESIGN: Observational: review of radiology department data. SETTING: Rural hospital imaging services. PARTICIPANTS: CT scanning patients residing in Otago region during the study period. INTERVENTIONS: There is no intervention in this observational study. MAIN OUTCOME MEASURES: CT scanning rates and waiting times before and after the introduction of the rural scanner. RESULTS: Prior to the scanner being commissioned, there was a significant urban versus rural disparity in CT utilisation. Residents in the neighbouring urban centre were 1.4 times more likely to access CT (33.2 (95% confidence interval (CI) 32.2-34.2) versus 23.0 (95% CI 21.0-25.1) scans per 1000 residents per annum). Twenty months after the scanner was commissioned, the rate for the rural community had almost doubled to 45.6 (95% CI 43.0-48.2) and was 1.2 times greater than for the urban community. This difference was not sustained, and rural and urban communities had similar CT scanning rates in 2011 and 2012. Mean waiting time for residents in the rural community fell from 21.1 (95% CI 17.1-25.2) days prior to the scanner to 6.7 (95% CI 5.6-7.8) days after the scanner was commissioned. CONCLUSIONS: On-site CT increased the rural scanning rate, corrected the rural-urban disparity and reduced waiting times without apparent over servicing.