Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study.
To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition.



A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan.



Adult ED visits (aged ≥18 years) during 2009-2013, with or without receiving CT, were enrolled as the study participants.



For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay.



In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013).



ED CT utilisation rates increased significantly during 2009-2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective.
Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan Department of Medical Research, Center for Translational Medicine, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, Chung Shan Medical University, Taichung, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Nursing, College of Health, National Taichung University of Science and Technology, Taichung, Taiwan Department of Nursing, College of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Sung-Yuan
SY
Hu
School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan, Taiwan Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
Ming-Shun
MS
Hsieh
Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan.
Meng-Yu
MY
Lin
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
Chiann-Yi
CY
Hsu
Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Tzu-Chieh
TC
Lin
School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chorng-Kuang
CK
How
Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Chen-Yu
CY
Wang
Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Jeffrey Che-Hung
JC
Tsai
Department of Laboratory Medicine, Da-Jia Lee's General Hospital, Lee's Medical Corporation, Taichung, Taiwan Department of Laboratory Medicine, Yuan-Li Lee's General Hospital, Lee's Medical Corporation, Miaoli, Taiwan Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
Yu-Hui
YH
Wu
School of Medicine, Chung Shan Medical University, Taichung, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Clinical Laboratory, Drug Testing Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
Yan-Zin
YZ
Chang
D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013624:Taiwan; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data* / Q000639:trends*; D014218:Triage / Q000145:classification*; D055815:Young Adult
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