Abdominal imaging ordering patterns by referring provider specialty

Abstract

Purpose

Prior work has demonstrated marked growth in the volume of abdominal imaging performed by radiologists. However, decisions to pursue imaging are largely driven by referring providers. In this study, we take the novel approach of investigating abdominal imaging utilization patterns by referring provider specialty.

Methods

Data on imaging services were obtained from the 2014 DocGraph Medicare Referring Provider Utilization for Procedures (MrPUP) public use file. MrPUP contains aggregated transaction data for combinations of unique referring provider and service code. Imaging services were classified by modality and body region using the Neiman Institute Types of Service (NITOS). Each referring provider’s specialty was determined using Medicare Physician Compare. Abdominal imaging ordering patterns were summarized by referring specialty.

Results

The final dataset included 5,824,754 abdominal imaging transactions. The most common ordering specialties of abdominal imaging were as follows: (1) internal medicine; (2) urology; (3) emergency medicine; (4) family practice; and (5) gastroenterology. The most common ordering specialties by abdominal imaging modality were emergency medicine for CT; gastroenterology for MRI and nuclear medicine; and internal medicine for ultrasound and radiography. While numerous specialties commonly ordered abdominal radiography and CT, urologists also commonly ordered retroperitoneal ultrasound and retrograde urography, and gastroenterologists also commonly ordered abdominal ultrasound, abdominal MRI, and esophagrams. Internal medicine, family practice, and emergency medicine providers ordered a much broader mix of imaging, including many non-abdominal imaging examinations.

Conclusion

Referring specialty abdominal imaging ordering patterns are varied but distinct. Awareness of these patterns may facilitate focused educational and policy initiatives to improve abdominal imaging appropriateness and utilization.

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Correspondence to Andrew B. Rosenkrantz.

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Funding

Authors Andrew B. Rosenkrantz and Richard Duszak Jr. are supported by research grants from the Harvey L. Neiman Health Policy Institute.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Rosenkrantz, A.B., Ayoola, A. & Duszak, R. Abdominal imaging ordering patterns by referring provider specialty. Abdom Radiol 42, 2363–2368 (2017). https://doi.org/10.1007/s00261-017-1121-8

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Keywords

  • Abdominal imaging
  • Referring provider
  • Physician specialties
  • Medicare
  • Utilization
  • Health policy