Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Unity Health Toronto, Toronto, Ontario, Canada.
PLoS One. 2023 Feb 3;18(2):e0281327. doi: 10.1371/journal.pone.0281327. eCollection 2023.
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.
影像学检查通常在住院患者中进行，等待这些检查可能会延长住院时间。本研究的目的是量化内科住院患者影像学检查的延迟，并确定导致延迟的患者、医生和系统因素。
这是一项回顾性队列研究，纳入了 2010 年至 2019 年在安大略省多伦多市的 5 家医院住院的至少接受过一次影像学检查（CT、MRI、超声或外周置入中心导管[PICC]置入）的内科住院患者。主要结局是检查时间，次要结局是检查后急性住院时间。
研究队列包括 73107 例住院患者。MRI 的检查时间最长（中位数为 22 小时），CT 的检查时间最短（中位数为 7 小时）。导致检查时间延长的最大因素是系统因素，如医院地点（最多延长 22 小时）、检查申请地点（最多延长 10 小时）、检查申请与入院时间的相对时间（最多延长 13 小时）以及周末申请（最多延长 21 小时）。患者年龄较大、合并症较多以及居住在低收入社区也与检查延迟有关。每多等待一个小时检查，检查后急性住院时间就会增加，从 CT 检查的 0.4 小时到 MRI 检查的 1.2 小时不等。
导致检查延迟的最大因素与何时何地进行检查有关。等待时间会影响住院时间和患者护理质量。医院可以采用我们的新方法来探索减少局部检查延迟的机会。
