Dianna M. Ehrhart Bardo MD, Presenter: Nothing to Disclose

Amariek Jensen, Abstract Co-Author: Nothing to Disclose

Beverly Plost, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Increased availability and utilization of CT has resulted in increased radiation exposure to children. Radiation exposure is not without risk; theoretically a cause cancer and genetic effects in the offspring of patients. The use of CT has escalated to 68.7 million exams in 2007, a 229% increase in the number of exams since 1980. Additionally, health care expenses are escalating. For example, in 1980 healthcare represented 8.8% ($245.8 billion) of gross domestic product (GDP) and by 2008 it represented 17% ($2.4 trillion) of GDP. Therefore we sought to evaluate clinical understanding of the relationship between the increasing use of CT as an imaging modality in children and the escalation of health care expenses.  

We sent an email survey to medical students, residents, pediatricians and ER physicians to determine their knowledge of CT radiation dose, dangers of radiation exposure, expense of CT and their ordering habits in children, as well as their opinion regarding escalating healthcare expenses. Following a 3 week period of email and intradepartmental education, we retested subjects.

Our study subjects showed a range of understanding of CT radiation dose, dangers of radiation exposure and expense of CT from sophisticated to naïve which did not correlate with education/training. Nearly universally, understanding of CT radiation dose was improved following education. Opinions on how the nation should proceed with healthcare reform are broad. These initiatives have sparked the interest of leaders in pediatric healthcare reform in Washington, D.C. and will hopefully be used to direct proposals toward improving delivery of CT in children.  

Pediatric healthcare reform encompasses many facets. Reforming safe delivery and ordering practices of CT in children will highlight some of the issues related to improving pediatric healthcare and should be used as a model for how radiology can contribute to restructuring the national healthcare system of the United States.

Within radiology, the path to pediatric healthcare reform must address best practice and best performance in order to achieve goals of reducing excessive radiation exposure and healthcare expenses.

Bardo, D, Jensen, A, Plost, B, Initiatives in Pediatric Healthcare Reform: Can Reforming Excesses in CT Scan Ordering Practices and Decreasing CT Radiation Exposure in Children Be Used as a Model for Reducing Medical Expenses as Our Nation Moves to Restructure National Healthcare?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8012442.html