McKinley Glover1, Dania Daye2, Omid Khalilzadeh3, Oleg Pianykh2, Daniel I Rosenthal2, James A Brink2, Efrén J Flores4. 1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Massachusetts General Physicians Organization, Boston, Massachusetts. 2. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 3. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Mount Sinai Beth Israel Hospital, New York, New York. 4. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: ejflores@mgh.harvard.edu.
Abstract
PURPOSE: The extent to which racial and socioeconomic disparities exist in accessing clinically appropriate, advanced diagnostic imaging has not been well studied. This study assesses the relationship between demographic and socioeconomic factors and the incidence of imaging missed care opportunities (IMCOs). METHODS: We performed a retrospective review of outpatient CT and MRI appointments at a quaternary academic medical center and affiliated outpatient facilities during a 12-month period. Missed appointments not rescheduled in advance were classified as IMCOs. Appropriateness criteria scores and demographics were also obtained. Univariate and multivariate analyses were performed to determine if demographic and socioeconomic factors were predictive of IMCOs. RESULTS: Overall, 57,847 patients met inclusion criteria, representing 89,943 scheduled unique imaging appointments of which 5,840 (6.1%) were IMCOs; 0.8% of IMCO appointments had low appropriateness scores compared with 1.2% of completed appointments (P < .01). Appointments covered by commercial insurance (5.2%) had a significantly lower rate of IMCOs than other payers: Medicare = 6.3%, Medicaid = 14.5%, self-pay = 12.0% (P < .05). The following factors were independent predictors of a patient having ≥ 1 IMCO: noncommercial insurance [odds ratio (OR) = 1.7-2.6], African American (OR = 1.8), Hispanic (OR = 1.2), other race (OR = 1.1), language other than English or Spanish (OR = 1.2), male gender (OR = 1.2), age ≥ 65 (OR = 0.71), and median household income of patient home zip code <$50,000 (OR = 1.4). CONCLUSIONS: Race and socioeconomic status are independent predictors of IMCOs. In efforts to enhance patient engagement, radiologists should be aware of the impact of race and socioeconomic status on access to clinically appropriate advanced diagnostic imaging.
PURPOSE: The extent to which racial and socioeconomic disparities exist in accessing clinically appropriate, advanced diagnostic imaging has not been well studied. This study assesses the relationship between demographic and socioeconomic factors and the incidence of imaging missed care opportunities (IMCOs). METHODS: We performed a retrospective review of outpatient CT and MRI appointments at a quaternary academic medical center and affiliated outpatient facilities during a 12-month period. Missed appointments not rescheduled in advance were classified as IMCOs. Appropriateness criteria scores and demographics were also obtained. Univariate and multivariate analyses were performed to determine if demographic and socioeconomic factors were predictive of IMCOs. RESULTS: Overall, 57,847 patients met inclusion criteria, representing 89,943 scheduled unique imaging appointments of which 5,840 (6.1%) were IMCOs; 0.8% of IMCO appointments had low appropriateness scores compared with 1.2% of completed appointments (P < .01). Appointments covered by commercial insurance (5.2%) had a significantly lower rate of IMCOs than other payers: Medicare = 6.3%, Medicaid = 14.5%, self-pay = 12.0% (P < .05). The following factors were independent predictors of a patient having ≥ 1 IMCO: noncommercial insurance [odds ratio (OR) = 1.7-2.6], African American (OR = 1.8), Hispanic (OR = 1.2), other race (OR = 1.1), language other than English or Spanish (OR = 1.2), male gender (OR = 1.2), age ≥ 65 (OR = 0.71), and median household income of patient home zip code <$50,000 (OR = 1.4). CONCLUSIONS: Race and socioeconomic status are independent predictors of IMCOs. In efforts to enhance patient engagement, radiologists should be aware of the impact of race and socioeconomic status on access to clinically appropriate advanced diagnostic imaging.
Authors: Garry Choy; Omid Khalilzadeh; Mark Michalski; Synho Do; Anthony E Samir; Oleg S Pianykh; J Raymond Geis; Pari V Pandharipande; James A Brink; Keith J Dreyer Journal: Radiology Date: 2018-06-26 Impact factor: 11.105
Authors: Donghoon Shin; Michael D C Fishman; Michael Ngo; Jeffrey Wang; Christina A LeBedis Journal: J Am Coll Radiol Date: 2022-01 Impact factor: 5.532
Authors: Martina Gurgitano; Salvatore Alessio Angileri; Giovanni Maria Rodà; Alessandro Liguori; Marco Pandolfi; Anna Maria Ierardi; Bradford J Wood; Gianpaolo Carrafiello Journal: Radiol Med Date: 2021-04-16 Impact factor: 3.469
Authors: Edgar Y Chou; Kari Moore; Yuzhe Zhao; Steven Melly; Lily Payvandi; James W Buehler Journal: J Gen Intern Med Date: 2021-06-22 Impact factor: 5.128