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Hospitals still order too many CT scans

Consumer Reports News: December 27, 2012 10:08 AM

Radiation exposure from a CT scan is about 350 times higher than from an ordinary chest X-ray. Yet some hospitals, including several large, well-known ones, continue to order too many of them, exposing patients to needless risk and expense, according our updated hospital Ratings.

We focused on "double scans," or two scans ordered for the same patient, one with a contrast agent (which can make the image clearer), and another without. Such double scans are rarely necessary, and expose patients to 700 times as much radiation as from a standard chest X-ray. Such scans might increase the risk of cancer. Contrast agents add other risks, including possible harm to the kidneys and allergic reactions. And, of course, any unnecessary test is a waste of money, too.

We looked at the number of such double scans at hospitals across the U.S. and found that the percentage of hospitals earning our best score for limiting unnecessary scans did increase, from 19 percent for 2008 to 27 percent for 2010, the most recent year for which data are available. To get a top score, a hospital must do double scans of at most 5 percent of patients who get an abdominal or chest scan. The data come from the Centers for Medicare & Medicaid Services.

The bad news is that far too many hospitals still do double scans: In 250 hospitals that were poor performers in our first analysis, with double-scan rates of 15 percent or more, rates for abdominal scans, chest scans, or both stayed the same or rose.

That group includes mainly small community hospitals but also some large, well-known ones. Among them: Cleveland Clinic Hospital in Weston, Fla.; John Stroger Jr. Hospital in Chicago; Memorial Health University Medical Center in Savannah, Ga.; University of California Irvine Medical Center in Orange, Calif.; and University of Medicine and Dentistry of New Jersey in Newark.

Bottom line: Avoiding unnecessary tests once you're in the hospital is challenging, because you or someone who cares for you must ask difficult questions of the staff. So even before checking into a hospital, consider checking our hospital Ratings. If a doctor orders a CT scan, ask whether an imaging test that doesn't emit radiation, such as an MRI or an ultrasound, could be used instead. And if you're told you need a second CT scan of your chest or abdomen, ask whether it's really necessary.

And see our article How Safe Is Your Hospital and our tips for staying safe in the hospital.

Joel Keehn

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