Factors Associated With Imaging of Nontraumatic Headaches in Virginia Emergency Departments
Abstract
PURPOSE: To explore whether patient-reported demographics and hospital classifications were significant factors in the likelihood that a computed tomography (CT) scan of the head would be ordered for nontraumatic headaches.
METHODS: Nonexperimental, cross-sectional analysis was performed on a database that included 18 279 patients presenting to emergency departments (EDs) in the Commonwealth of Virginia. Information included in the analysis was diagnosis of a generalized, nontraumatic headache; patient age and sex; the treating hospital's profit status (ie, for-profit vs nonprofit); status of the hospital as a teaching institution; hospital location (ie, rural vs suburban and urban); diagnostic procedures ordered; and patient's insurance coverage (commercial insurance, Medicare, or Medicaid). Descriptive statistics, chi-square, and binary logistic regression analyses were performed.
RESULTS: Approximately 10% of patients who presented to EDs with a chief complaint of headache received a diagnostic head CT scan. Patient age proved to be the only significant variable in the analysis (P ≤ .001). Hospital's teaching status, classification as rural or suburban and urban, and profit status were not significant factors in determining the likelihood of a head CT being performed, nor were any other demographic variables studied.
DISCUSSION: Radiologic procedure expenditures have increased more than any other physician service in the past 2 decades. The increase in CT use warrants…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 18 participants or records.
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