Imaging delays among medical inpatients in Toronto, Ontario: A cohort study
Imaging procedures are commonly performed on hospitalized patients and waiting for these could increase length-of-stay. The study objective was to quantify delays for imaging procedures in General Internal Medicine and identify contributing patient, physician, and system factors. This was a retrospe...
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| Veröffentlicht in: | PloS one 2023-02, Vol.18 (2), p.e0281327-e0281327 |
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| creator | Bartsch, Emily Shin, Saeha Roberts, Surain MacMillan, Thomas E Fralick, Michael Liu, Jessica J Tang, Terence Kwan, Janice L Weinerman, Adina Verma, Amol A Razak, Fahad Lapointe-Shaw, Lauren |
| description | Imaging procedures are commonly performed on hospitalized patients and waiting for these could increase length-of-stay. The study objective was to quantify delays for imaging procedures in General Internal Medicine and identify contributing patient, physician, and system factors.
This was a retrospective cohort study of medical inpatients admitted to 5 hospitals in Toronto, Ontario (2010-2019), with at least one imaging procedure (CT, MRI, ultrasound, or peripherally-inserted central catheter [PICC] insertion). The primary outcome was time-to-test, and the secondary outcome was acute length-of-stay after test ordering.
The study cohort included 73,107 hospitalizations. Time-to-test was longest for MRI (median 22 hours) and shortest for CT (median 7 hours). The greatest contributors to time-to-test were system factors such as hospital site (up to 22 additional hours), location of test ordering (up to 10 additional hours), the timing of test ordering relative to admission (up to 13 additional hours), and ordering during weekends (up to 21 additional hours). Older patient age, having more comorbidities, and residence in a low-income neighborhood were also associated with testing delays. Each additional hour spent waiting for a test was associated with increased acute length-of-stay after test ordering, ranging from 0.4 additional hours for CT to 1.2 hours for MRI.
The greatest contributors to testing delays relate to when and where a test was ordered. Wait times affect length-of-stay and the quality of patient care. Hospitals can apply our novel approach to explore opportunities to decrease testing delays locally. |
| doi_str_mv | 10.1371/journal.pone.0281327 |
| format | Article |
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This was a retrospective cohort study of medical inpatients admitted to 5 hospitals in Toronto, Ontario (2010-2019), with at least one imaging procedure (CT, MRI, ultrasound, or peripherally-inserted central catheter [PICC] insertion). The primary outcome was time-to-test, and the secondary outcome was acute length-of-stay after test ordering.
The study cohort included 73,107 hospitalizations. Time-to-test was longest for MRI (median 22 hours) and shortest for CT (median 7 hours). The greatest contributors to time-to-test were system factors such as hospital site (up to 22 additional hours), location of test ordering (up to 10 additional hours), the timing of test ordering relative to admission (up to 13 additional hours), and ordering during weekends (up to 21 additional hours). Older patient age, having more comorbidities, and residence in a low-income neighborhood were also associated with testing delays. Each additional hour spent waiting for a test was associated with increased acute length-of-stay after test ordering, ranging from 0.4 additional hours for CT to 1.2 hours for MRI.
The greatest contributors to testing delays relate to when and where a test was ordered. Wait times affect length-of-stay and the quality of patient care. Hospitals can apply our novel approach to explore opportunities to decrease testing delays locally.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281327</identifier><identifier>PMID: 36735736</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Care and treatment ; Catheterization ; Cohort analysis ; Cohort Studies ; Comorbidity ; Computed tomography ; CT imaging ; Diagnostic imaging ; Evaluation ; Health care access ; Hospital patients ; Hospitalization ; Hospitals ; Humans ; Hypotheses ; Hypothesis testing ; Inpatients ; Laboratories ; Length of Stay ; Magnetic resonance imaging ; Medical care ; Medical imaging ; Medical imaging equipment ; Medical instruments ; Medicine and Health Sciences ; Mortality ; Ontario ; Patients ; People and Places ; Physicians ; Quality management ; Research and Analysis Methods ; Retrospective Studies ; Ultrasonic imaging ; Variables</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0281327-e0281327</ispartof><rights>Copyright: © 2023 Bartsch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Bartsch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Bartsch et al 2023 Bartsch et al</rights><rights>2023 Bartsch et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-df26784870d1e678a7d18aa5b5a0ff4e985e58347d06254e9e2daf1e9d372fd3</citedby><cites>FETCH-LOGICAL-c692t-df26784870d1e678a7d18aa5b5a0ff4e985e58347d06254e9e2daf1e9d372fd3</cites><orcidid>0000-0001-8792-2240 ; 0000-0002-8794-6493</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897551/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897551/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36735736$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Strumann, Christoph</contributor><creatorcontrib>Bartsch, Emily</creatorcontrib><creatorcontrib>Shin, Saeha</creatorcontrib><creatorcontrib>Roberts, Surain</creatorcontrib><creatorcontrib>MacMillan, Thomas E</creatorcontrib><creatorcontrib>Fralick, Michael</creatorcontrib><creatorcontrib>Liu, Jessica J</creatorcontrib><creatorcontrib>Tang, Terence</creatorcontrib><creatorcontrib>Kwan, Janice L</creatorcontrib><creatorcontrib>Weinerman, Adina</creatorcontrib><creatorcontrib>Verma, Amol A</creatorcontrib><creatorcontrib>Razak, Fahad</creatorcontrib><creatorcontrib>Lapointe-Shaw, Lauren</creatorcontrib><title>Imaging delays among medical inpatients in Toronto, Ontario: A cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Imaging procedures are commonly performed on hospitalized patients and waiting for these could increase length-of-stay. The study objective was to quantify delays for imaging procedures in General Internal Medicine and identify contributing patient, physician, and system factors.
This was a retrospective cohort study of medical inpatients admitted to 5 hospitals in Toronto, Ontario (2010-2019), with at least one imaging procedure (CT, MRI, ultrasound, or peripherally-inserted central catheter [PICC] insertion). The primary outcome was time-to-test, and the secondary outcome was acute length-of-stay after test ordering.
The study cohort included 73,107 hospitalizations. Time-to-test was longest for MRI (median 22 hours) and shortest for CT (median 7 hours). The greatest contributors to time-to-test were system factors such as hospital site (up to 22 additional hours), location of test ordering (up to 10 additional hours), the timing of test ordering relative to admission (up to 13 additional hours), and ordering during weekends (up to 21 additional hours). Older patient age, having more comorbidities, and residence in a low-income neighborhood were also associated with testing delays. Each additional hour spent waiting for a test was associated with increased acute length-of-stay after test ordering, ranging from 0.4 additional hours for CT to 1.2 hours for MRI.
The greatest contributors to testing delays relate to when and where a test was ordered. Wait times affect length-of-stay and the quality of patient care. 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and waiting for these could increase length-of-stay. The study objective was to quantify delays for imaging procedures in General Internal Medicine and identify contributing patient, physician, and system factors.
This was a retrospective cohort study of medical inpatients admitted to 5 hospitals in Toronto, Ontario (2010-2019), with at least one imaging procedure (CT, MRI, ultrasound, or peripherally-inserted central catheter [PICC] insertion). The primary outcome was time-to-test, and the secondary outcome was acute length-of-stay after test ordering.
The study cohort included 73,107 hospitalizations. Time-to-test was longest for MRI (median 22 hours) and shortest for CT (median 7 hours). The greatest contributors to time-to-test were system factors such as hospital site (up to 22 additional hours), location of test ordering (up to 10 additional hours), the timing of test ordering relative to admission (up to 13 additional hours), and ordering during weekends (up to 21 additional hours). Older patient age, having more comorbidities, and residence in a low-income neighborhood were also associated with testing delays. Each additional hour spent waiting for a test was associated with increased acute length-of-stay after test ordering, ranging from 0.4 additional hours for CT to 1.2 hours for MRI.
The greatest contributors to testing delays relate to when and where a test was ordered. Wait times affect length-of-stay and the quality of patient care. Hospitals can apply our novel approach to explore opportunities to decrease testing delays locally.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36735736</pmid><doi>10.1371/journal.pone.0281327</doi><tpages>e0281327</tpages><orcidid>https://orcid.org/0000-0001-8792-2240</orcidid><orcidid>https://orcid.org/0000-0002-8794-6493</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-02, Vol.18 (2), p.e0281327-e0281327 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2772269411 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Biology and Life Sciences Care and treatment Catheterization Cohort analysis Cohort Studies Comorbidity Computed tomography CT imaging Diagnostic imaging Evaluation Health care access Hospital patients Hospitalization Hospitals Humans Hypotheses Hypothesis testing Inpatients Laboratories Length of Stay Magnetic resonance imaging Medical care Medical imaging Medical imaging equipment Medical instruments Medicine and Health Sciences Mortality Ontario Patients People and Places Physicians Quality management Research and Analysis Methods Retrospective Studies Ultrasonic imaging Variables |
| title | Imaging delays among medical inpatients in Toronto, Ontario: A cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T23%3A51%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Imaging%20delays%20among%20medical%20inpatients%20in%20Toronto,%20Ontario:%20A%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Bartsch,%20Emily&rft.date=2023-02-03&rft.volume=18&rft.issue=2&rft.spage=e0281327&rft.epage=e0281327&rft.pages=e0281327-e0281327&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0281327&rft_dat=%3Cgale_plos_%3EA735720846%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2772269411&rft_id=info:pmid/36735736&rft_galeid=A735720846&rft_doaj_id=oai_doaj_org_article_9b731a7667de4ceebe56502b6be10164&rfr_iscdi=true |