Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
West J Emerg Med. 2011 Feb;12(1):90-5.

Differential use of diagnostic ultrasound in u.s. Emergency departments by time of day.

Author information

  • 1University of California, San Francisco.

Abstract

BACKGROUND:

Survey data over the last several decades suggests that emergency department (ED) access to diagnostic ultrasound performed by the radiology department is unreliable, particularly outside of regular business hours.

OBJECTIVE:

To evaluate the association between the time of day of patient presentation and the use of diagnostic ultrasound services in United States (U.S.) EDs.

METHODS:

This was a cross-sectional study of ED patient visits using the National Hospital Ambulatory Medical Care Survey for the years 2003 to 2005. Our main outcome measure was the use of diagnostic ultrasound during the ED patient visit as abstracted from the medical record. We performed multivariate analyses to identify any association between ultrasound use and time of presentation for all patients, as well as for two subgroups who are more likely to need ultrasound as part of their routine workup: patients at risk of deep venous thrombosis, and patients at risk for ectopic pregnancy.

RESULTS:

During the three-year period, we analyzed 110,447 patient encounters, representing 39 million national visits. Of all ED visits, 2.6% received diagnostic ultrasound. Presenting to the ED "off hours" (defined as Monday through Friday 7pm to 7am and weekends) was associated with a lower rate of ultrasound use independent of potential confounders (odds ratio [OR] 0.73, 95% confidence interval [CI]: 0.65 - 0.82). Patients at increased risk of deep venous thrombosis who presented to the ED during "off hours" were also less likely to undergo diagnostic ultrasound (OR 0.34, 95% CI: 0.15 - 0.79). Similarly, patients at increased risk of ectopic pregnancy received fewer diagnostic ultrasounds during "off hours" (OR 0.56, 95% CI 0.35 - 0.91).

CONCLUSION:

In U.S. EDs, ultrasound use was lower during "off hours," even among patient populations where its use would be strongly indicated.

PMID:
21691478
[PubMed]
PMCID:
PMC3088381
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Emergency Medicine department, University of California Irvine Icon for PubMed Central
    Loading ...
    Write to the Help Desk