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Self-referred Whole-Body Imaging: Where Are We Now?¹

¹ From the Department of Diagnostic Radiology, Yale University School of Medicine, 330 Cedar St, TE-2, New Haven, CT 06510 (G.M.K., H.P.F.); Research Department, American College of Radiology, Reston, Va (M.B., J.H.S.); and Department of Economics, Yale College, and School of Management, Yale University, New Haven, Conn (H.P.F.). Received December 5, 2003; revision requested February 6, 2004; revision received March 5; accepted March 31. Address correspondence to H.P.F. (e-mail: howard.forman@yale.edu).

PURPOSE: To identify current patterns and trends of computed tomographic (CT) screening, including geographic data, services provided, facility type, and demographic characteristics.

MATERIALS AND METHODS: In March 2003, self-referred body imaging (SRBI) centers were identified by using the Internet. Data involving geographic location, type of facility, services provided, and demographic characteristics were collected. The 2000 U.S. census data were used to compare center locality demographics with national patterns. Descriptive statistics, t tests, and regression analyses were used to evaluate data. Nonstatistical comparisons were made with results obtained from a previously published analysis.

RESULTS: The number of SRBI centers totaled 161 (vs 88 in a comparative study in 2001), and centers were distributed across 31 states and Washington, DC (vs 21 in 2001). Racial demographics of center localities more closely resembled national averages in the current study, with equal percentages of whites (76.0% vs 77.1% nationally) and Hispanics (11.5% vs 12.5% nationally). Center localities continued to exhibit greater wealth and levels of education, as reflected by higher income per capita and median household income (P < .05), as well as by higher percentages of people with college and advanced degrees (P < .05). Heart scanning was the most commonly offered service (n = 152, 94%), followed by whole-body scanning (n = 135, 84%), lung scanning (n = 126, 78%), and virtual colonoscopy (n = 88, 55%). Centers in the West were more likely to offer whole-body and organ-specific scanning, compared with centers in other regions (P < .001 for virtual colonoscopy, P < .05 for head scanning). Hospital-based centers were less likely to offer services other than heart scanning (P < .001).

CONCLUSION: Compared with results of a prior analysis, SRBI centers have increased and are distributed more widely in areas with a population that more closely resembles national norms. The increased trend to broaden services may suggest possible saturation of the preexisting market.

© RSNA, 2004

Index terms: Computed tomography (CT) • Computed tomography (CT), utilization • Economics, medical • Radiology and radiologists, socioeconomic issues • Self referral

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