Inefficiency, dignity and patient experience: is it time for separate outpatient diagnostics?

There is international and national variation in the location of diagnostic imaging centres relative to hospitals. Diagnostic cross-sectional imaging has traditionally been performed within a hospital, catering for both inpatient and outpatients. The resulting two-tiered system caters for emergent and complex inpatients, in addition to typically ambulatory outpatients. These outpatients are less complex, and often attend an acute hospital for the specific purpose of diagnostic imaging. In both the UK and the Republic of Ireland, outpatient radiology is often provided on-campus in state-funded hospitals, reflecting the allocation of resources nationally. In many other countries, hospitals provide acute and high-level care, with community centres addressing outpatients' clinical and diagnostic needs. Mixing inpatients and outpatients introduces variability into the scanning process, and many institutions struggle to provide for the very different needs of outpatients. Current strategies of mixing these two fundamentally different groups should be reassessed, and either in-hospital segregation or dedicated outpatient diagnostic imaging centres merit serious consideration in any future healthcare planning.