title: Implementation of 24/7 radiology services in an academic medical centre level 1 trauma centre: impact on trauma resuscitation unit length of stay and economic benefit analysis.
abstract: OBJECTIVE
  To evaluate the impact of 24/7 radiology services on trauma resuscitation unit (TRU) length of stay (LOS) for patients with minor trauma and to analyse the economic benefits of such an impact from trauma centre perspective.
  
  
  METHODS
  The study was HIPAA compliant and had IRB approval. Data were extracted from hospital and radiology information systems. Inclusion criteria specified patients: (a) with minor trauma (i.e., Injury Severity Score<16 and Maximum Abbreviated Injury Scale<4); (b) cross-sectional imaging performed between 12 and 7AM; and (c) admission during 2006 (before 24/7 coverage; comparison group 1) or 2007 (24/7 coverage). Mean, median, standard deviation, and variance for the groups were determined. The theoretical economic benefit achieved with 24/7 radiology coverage was estimated from decreases in TRU LOS for each patient.
  
  
  RESULTS
  Totals of 1087 and 1323 patients for 2006 and 2007, respectively, met our selection criteria. Mean TRU LOS decreased from 11.19 to 8.25 h (26%; P<0.001). The median decreased from 10.8 to 7.2 h (33%; P<0.001). The (Q3-Q1) indicator, used as a proxy for variance and spread, decreased from 7.36 to 5.76 h. Theoretical economic benefits from 24/7 radiology coverage were achieved by the product of TRU bed fixed costs with mean decrease in TRU LOS for the calendar year 2007, which equaled $340,069.
  
  
  CONCLUSIONS
  The economic benefits of 24/7 radiology services are related to LOS, which can be shortened by limiting patient discharge delays resulting from report unavailability. This can be a cost-saving replacement for conventional radiology practice when the trauma centre makes appropriate use of vacant TRU beds to realise its opportunity cost.
authors: Department of Radiology, University of Maryland Medical Center, Baltimore, MD, United States. ubodanapally@umm.edu
authors: Uttam K
authors: UK
authors: Bodanapally
authors: Kathirkamanathan
authors: K
authors: Shanmuganathan
authors: Kavitha
authors: K
authors: Nutakki
authors: Stuart E
authors: SE
authors: Mirvis
authors: Clint W
authors: CW
authors: Sliker
authors: Narendra
authors: N
authors: Shet
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000191:economics*; D011859:Radiography; D011872:Radiology Department, Hospital / Q000191:economics / Q000458:organization & administration / Q000592:standards / Q000639:trends; D012151:Resuscitation / Q000191:economics*; D012189:Retrospective Studies; D013997:Time Factors; D014193:Trauma Centers / Q000191:economics; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000191:economics* / Q000453:epidemiology