title: Radiology imaging delays as independent predictors of length of hospital stay for emergency medical admissions.
abstract: OBJECTIVE
  To investigate the extent to which the time to completion for computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound could be shown to influence the length of stay and costs incurred while in hospital, while accounting for patient acuity.
  
  
  METHODS
  All emergency admissions, totalling 25,326 imaging investigations between 2010-2014 were evaluated. The 50(th), 75(th), and 90(th) centiles of completion times for each imaging type was entered into a multivariable truncated Poisson regression model predicting the length of hospital stay. Estimates of risk (odds or incidence rate ratios [IRRs]) of the regressors were adjusted for acute illness severity, Charlson comorbidity index, chronic disabling disease score, and sepsis status. Quantile regression analysis was used to examine the impact of imaging on total hospital costs.
  
  
  RESULTS
  For all imaging examinations, longer hospital lengths of stay were shown to be related to delays in imaging time. Increased delays in CT and MRI were shown to be associated with increased hospital episode costs, while ultrasound did not independently predict increased hospital costs. The magnitude of the effect of imaging delays on episode costs were equivalent to some measures of illness severity.
  
  
  CONCLUSIONS
  CT, MRI, and ultrasound are undertaken in patients with differing clinical complexity; however, even with adjustment for complexity, the time delay in a more expeditious radiological service could potentially shorten the hospital episode and reduce costs.
authors.affiliation: Medical Physics and Bioengineering Department, St James's Hospital, Dublin 8, Ireland. Electronic address: scournane@stjames.ie.
authors.forename: S
authors.initials: S
authors.lastname: Cournane
authors.affiliation: Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Conway
authors.affiliation: Information Management Systems, St James's Hospital, Dublin 8, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Creagh
authors.affiliation: Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
authors.forename: D G
authors.initials: DG
authors.lastname: Byrne
authors.affiliation: Diagnostic Imaging Department, St James's Hospital, Dublin 8, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: Sheehy
authors.affiliation: Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Silke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000191:economics* / Q000401:mortality; D003952:Diagnostic Imaging / Q000191:economics* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000191:economics* / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D011871:Radiology / Q000191:economics; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D014850:Waiting Lists / Q000401:mortality*