title: Effect of mandatory radiology consultation on inpatient imaging use. A randomized controlled trial.
abstract: OBJECTIVE
  To determine if a mandatory radiology consultation service can decrease radiology resource use on inpatient internal medicine services.
  
  
  METHODS
  Randomized controlled trial on 4 internal medicine services at a university hospital.
  
  
  METHODS
  Six radiologists performed the intervention on 2 internal medicine services over a 12-month period. A total of 1022 patients were admitted to the 2 intervention services and 1178 patients were admitted to the 2 control services. Each was staffed by an attending internist and 3 house officers.
  
  
  METHODS
  Each radiology examination required approval by the attending radiologist before it was performed.
  
  
  METHODS
  Relative resource costs (relative value units [RVUs]), number of examinations per patient, proportion of patients with 1 or more tests, and mean length of stay (LOS).
  
  
  RESULTS
  Mean RVUs for the intervention group were 356.1, and for the control group, 336.0 (P=.5). Mean examinations per patient for both groups was 4.4. Mean LOS for the intervention group was 6.0 days, and for the control group, 6.1 days (P=.8).
  
  
  CONCLUSIONS
  An inpatient radiology consultation service, with a goal to reduce resource use, did not achieve its goal. A more appropriate use of time and expense for radiology utilization management may be in the outpatient setting.
authors.affiliation: Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109-0030, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Bree
authors.forename: E A
authors.initials: EA
authors.lastname: Kazerooni
authors.forename: S J
authors.initials: SJ
authors.lastname: Katz
mesh_terms: D005260:Female; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D007388:Internal Medicine; D007902:Length of Stay; D008297:Male; D017064:Process Assessment, Health Care / Q000191:economics; D011872:Radiology Department, Hospital / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*