Characterization and Targeting of the Main Drivers of Elective Imaging Utilization: A Cross-Sectional Study Applying Conjoint Analysis

Objective

To characterize patient and referring physician preferences when selecting where to have elective imaging performed.

Methods

In this institutional research board–approved survey-based study, online surveys were completed by 393 patients who had recently had a noncontrast MRI of the shoulder, lumbar spine, or knee within the past 2 years and 168 physicians who had ordered at least 12 such MRIs in the past year. The survey data included explicit questions about preferences as well as a set of conjoint choice screens. Conjoint analysis used a logistic model estimated using maximum likelihood estimation. Additionally, latent class analysis was performed to evaluate segmentation of the market.

Results

Both patients and referring physicians placed most value on copay and cost, with both groups containing a large segment that places almost all value on low costs. Patients also valued the recommendation of their referring physician and convenient appointment time and location. Overall, physicians also valued image quality and a trusted radiologist, with one physician segment placing more value on these traits than cost. As expected, there was some variation between the relative importance of traits depending on whether respondents were ranking, rating, or implicitly valuing characteristics.

Discussion

Overall, both patients and referring physicians place greatest importance on copay and cost but other nonmonetary characteristics have significant utility values, which could be leveraged to help radiology practices offer better services for their patients and referring physicians.