Effect of an Image-Sharing Network on CT Utilization for Transferred Trauma Patients: A 5-Year Experience at a Level I Trauma Center

Abstract

Objectives To evaluate the influence of an image sharing network established between referring hospitals and a level I trauma center on CT utilization at the trauma center. Methods This retrospective study was approved by the local Institutional Review Board. The requirement for informed consent was waived. We linked the Harborview Medical Center’s trauma registry to billing department data and obtained detailed information on all resources utilized during each patient’s hospitalization. We used negative binomial regression to evaluate the body-region specific CT utilization between direct admit and transfer patients after adjustment for potential confounding variables. We paid special attention to 2005 as the year that we established Internet-based image sharing between HMC and referring hospitals. Results A total of 81,159 trauma patients were admitted to HMC (44% transfer) during the study period. The utilization of head CTs slightly increased from 1996 to 2005, with no significant difference between direct admits and transfer patients. Between 2005 and 2010, utilization remained relatively unchanged; however, we observed significantly higher utilization rates for direct admit patients. Relatively similar pattern was observed for pelvic CTs; however, between 2005 and 2010, CT use was greater for direct admits compared to transfer patients. Abdominal and thoracic CTs were relatively unchanged between 2005 and 2010. However, both CTs had significantly higher utilization rates for direct admits. Conclusion The utilization rate of different body regions CT was higher for direct admit trauma patients compared to transfer patients since 2005; however, decreasing utilization trends have been observed in recent years.

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