Domiciliary radiography: an important service?

General practitioners' (GP) perceptions, comparative costs and potential influence on patient management of a domiciliary radiography service were reviewed. A postal questionnaire was sent to 159 local GPs, 130 of whom responded. Seventy-one per cent of respondents had requested domiciliary radiography in the previous year and 79% felt loss of the service could potentially be detrimental. Although 98% recognized that a chest X-ray was a suitable domiciliary radiography examination, 6% thought that a barium swallow could be adequately carried out with domiciliary equipment. Forty-nine per cent perceived a need for a domiciliary ultrasound service. Sixty-three per cent believed that domiciliary radiography was cheaper than return ambulance transport with departmental examination, although estimates showed a domiciliary visit to cost 82 pounds versus 60 pounds for a departmental visit. A retrospective review of 50 consecutive domiciliary radiography examinations showed that elderly and immobile patients were imaged most frequently. Malignancy was diagnosed in 14%, infection in 26% and a fracture in 14%. Overall there was an anticipated management change in 50% of patients.