Radiology referrals patterns in a free clinic setting

Abstract

Purpose

To evaluate imaging referral completion rates in an urban, free clinic for underserved patients, including associated patient and imaging factors.

Materials and methods

In this IRB-approved single-center study, we retrospectively analyzed imaging referral orders associated with an urban, outpatient, free clinic from January 2017 to December 2022. Referrals were submitted to a tertiary academic center with the exception of a subset of ultrasound referrals that were processed onsite at a point-of-care ultrasound (POCUS) clinic, and a proportion of mammography referrals completed within mobile imaging units. Associations between patient and imaging-specific factors – and referral completion rates – were further evaluated.

Results

A total of 882 referrals were submitted for 629 unique patients (average age, 48 years; 67 % female). Of total referrals, 424 (48 %) were successfully completed. Of the major represented modalities, ultrasound was completed at a rate of 59 % compared to x-rays which were completed at a rate of 45 % and mammography which was completed at a rate of 37 %. On-site imaging services, namely POCUS and mobile mammography, led to more successfully completed imaging (77 % combined success rate) than off-site services (p < 0.0001). Patients for whom “Unknown” was documented for race/ethnicity identification (14 % of submissions) and language preference (9 % of submissions) were least likely to have successful completion of their referral (p < 0.0001).

Conclusion

Low success rates of completion for imaging referrals from our free clinic indicate the need for further efforts to ensure high-quality imaging care for corresponding patient populations, with mobile and point-of-care imaging being of potential utility.