title: Characterizing the performance of the nation's hospitals in the Hospital Outpatient Quality Reporting Program's imaging efficiency measures.
abstract: OBJECTIVE
  To describe the performance of the nation's hospitals in terms of the Hospital Outpatient Quality Reporting Program's imaging efficiency measures.
  
  
  METHODS
  Data were obtained from the Hospital Compare website and reflect outpatient Medicare claims of 4,118 hospitals for 5 imaging efficiency metrics: (1) frequency of combination abdominal CT (performed with and without intravenous contrast); (2) combination chest CT (performed with and without intravenous contrast); (3) simultaneous brain/sinus CT; (4) mammography follow-up (diagnostic imaging after screening mammography); and (5) lumbar spine MRI for low back pain without prior conservative therapy. Metrics were summarized and compared with other hospital characteristics.
  
  
  RESULTS
  Median frequency was 36.7% for lumbar spine MRI for low back pain and ranged from 1.6% to 7.8% for the remaining measures; however, extreme outliers were observed (maximal frequencies of 79.2%-95.2% for mammography follow-up and combination chest and abdominal CT). Essentially no correlation was found among measures, aside from combination abdominal and chest CT. For some measures, relatively poor performance was more commonly observed among critical access hospitals and physician-owned/proprietary hospitals, and less commonly observed among U.S. News & World Report "best" hospitals and primary residency teaching sites. Frequencies for combination abdominal and chest CT improved from 2013 to 2014 among hospitals with relatively poorer performance.
  
  
  CONCLUSIONS
  Although the imaging efficiency measures help identify individual hospitals and hospital categories with relatively inefficient imaging practices, they do not readily identify distinctly positively performing hospitals. Excess utilization was suggested for lumbar spine MRI. Frequency of combination abdominal and chest CT examinations improved over a short time interval.
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, New York. Electronic address: Andrew.Rosenkrantz@nyumc.org.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Rosenkrantz
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, New York.
authors.forename: Ankur
authors.initials: A
authors.lastname: Doshi
mesh_terms: D008279:Magnetic Resonance Imaging / Q000592:standards* / Q000706:statistics & numerical data*; D010044:Outpatient Clinics, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000592:standards* / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*; D014481:United States
keywords: CT; Medicare; Radiology; hospital; imaging utilization; quality; quality measures