Clinical Report: Pediatric Imaging Practices in Hospitals and Emergency Departments

Overview

This study examines pediatric imaging utilization across hospitals, highlighting disparities based on race, ethnicity, and insurance status. It emphasizes the need for improved pediatric emergency department readiness to enhance care quality and equity.

Background

Pediatric imaging practices are critical for ensuring appropriate care in emergency settings. Variability in imaging rates, particularly among racial and ethnic groups, raises concerns about equity in healthcare delivery. Understanding the factors influencing imaging utilization can help address these disparities and improve patient outcomes.

Data Highlights

In a study of pediatric imaging practices, it was found that:

• Imaging rates varied significantly across different racial and ethnic groups, with non-Hispanic White patients receiving more imaging than non-Hispanic Black and Hispanic patients.

• Hospital-level factors, including the presence of pediatric emergency care coordinators, were associated with higher imaging utilization rates.

• Insurance status was identified as a critical factor influencing imaging rates, often reflecting underlying socioeconomic disparities.

• There was evidence of overuse in specific imaging practices, particularly chest radiography for asthma and CT scans for head and abdominal trauma.

Key Findings

• Non-Hispanic White patients are more likely to receive imaging compared to non-Hispanic Black and Hispanic patients.

• Hospital-level factors significantly influence imaging utilization rates.

• Pediatric emergency department readiness, including the presence of a pediatric emergency care coordinator, is linked to improved care quality.

• Insurance status serves as a surrogate marker for socioeconomic status affecting imaging rates.

• Specific imaging practices, such as chest radiography for asthma and CT scans for head and abdominal trauma, show patterns of overuse.

Clinical Implications

Healthcare providers should be aware of the disparities in imaging utilization among different racial and ethnic groups. Implementing pediatric readiness interventions may help reduce these disparities and improve overall care quality in emergency settings.

Conclusion

Addressing the variability in pediatric imaging practices is essential for promoting health equity. Enhanced pediatric emergency department capabilities can lead to better outcomes for all patients.

Related Resources & Content

1. American Academy of Pediatrics, Pediatrics, 2024 -- Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Policy Statement

2. JAMA Network, Emergency Medicine, 2020 -- Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial

3. JAMA Network, Pediatrics, 2021 -- Racial and Ethnic Differences in Emergency Department Diagnostic Imaging at US Children’s Hospitals, 2016-2019

4. European Radiology — Minimizing Radiation Exposure While Maintaining Image Quality in Pediatric Cardiac Computed Tomography Using Photon-Counting Detectors Without Electrocardiographic Gating in Congenital Heart Disease

5. European Radiology — Assessment of Radiation Exposure and Associated Cancer Risk from Thoracic and Abdominal X-rays in 1307 Neonates

6. European Radiology — Advancements Over Two Decades in Pediatric Imaging Using a Reduced Dose of [18F]Fluorodeoxyglucose PET/CT and PET/MR Techniques

7. European Radiology — Establishing Diagnostic Reference Levels for Pediatric CT Based on Indications: Insights from an International Registry

8. Optimizing Advanced Imaging of the Pediatric Patient in the Emergency Department: Policy Statement | Pediatrics | American Academy of Pediatrics

9. Effect of the Head Computed Tomography Choice Decision Aid in Parents of Children With Minor Head Trauma: A Cluster Randomized Trial | Emergency Medicine | JAMA Network Open | JAMA Network

10. Racial and Ethnic Differences in Emergency Department Diagnostic Imaging at US Children’s Hospitals, 2016-2019 | Pediatrics | JAMA Network Open | JAMA Network