Self-Referral an Important Factor in Imaging Growth

A recent study suggests that self-referral in medical imaging may be a significant contributing factor in diagnostic imaging growth.

Self-referred imaging is identified as physicians (or nonphysicians) who are not radiologists directing their patients to their own on-site imaging services or the referral of patients to outside facilities in which the referring physicians have financial interest.

In the current political and economic climate in the United States, there is a desire to reduce healthcare costs; diagnostic imaging expenditure is one area of particular interest. Researchers identified the relative risk of physicians’ referring patients for imaging to facilities in which the physicians have financial interest (self-referrers) compared with physicians’ referring patients for imaging to facilities in which they have no financial interest (radiologist referrers).

“This meta-analysis of the available medical literature estimates that nonradiologist self-referrers of medical imaging are approximately 2.48 times more likely to order imaging than clinicians with no financial interest in imaging, which translates to an increased imaging utilization rate of 59.7%,” said Ramsey K. Kilani, MD, from Duke University Medical Center (Durham, NC, USA), and lead author of the study. “The utilization fraction of imaging attributable to self-referral in our study was calculated as 59.7%. According to the 2008 GAO [US Government Accountability Office] report, US$14.1 billion was spent on diagnostic imaging in 2006; of this amount, 64% [$9.0 billion] was to physician offices. Of that $9.0 billion, 68% went to nonradiologists. Using the 59.7% utilization fraction attributable to self-referral, a theoretical associated cost was calculated at $3.6 billion.”

The report was published in the July 2011 issue of the Journal of the American College of Radiology.

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Duke University Medical Center