A service evaluation of the clinical and cost effectiveness of a home-deployed mobile x-ray imaging service in a regional setting

Introduction

Falls in older adults are common, leading to high rates of emergency admissions, extended hospital stays, and unnecessary use of healthcare resources. This service evaluation reports on a home-deployed imaging service using mobile X-ray equipment to explore the potential cost-effectiveness and patient benefits of facilitating imaging at the patient's place of residence.

Methods

A six-month pilot program was established involving transporting portable imaging equipment to patients' homes or care facilities in Cornwall as required. Referrals were made by community clinicians via phone, and imaging results were integrated with existing hospital systems. Cost-benefit analysis was performed based on reduced ambulance usage and avoided hospital admissions. Patient satisfaction was assessed using a survey.

Results

305 patient referrals were made, resulting in 294 imaging visits. Most referrals (64.5 %) were to patients at home, with the remainder in care facilities. The majority of imaging involved hip (41.3 %) and lower limb (23.5 %) examinations. 87.4 % of patients were discharged at the scene, with the remaining 12.6 % requiring ambulance transport. Ambulance callouts were avoided in 257 cases, potentially saving over 19 total days of ambulance handover time. Patient feedback was predominately positive. The average age of patients imaged was 83 and the average frailty score was 6 (moderately frail).

Conclusions

The home-deployed imaging service was effective in reducing need for ambulance conveyance, number of emergency department admissions, and hospital stays, with high patient satisfaction.

Implications for practice

This pilot demonstrates the potential for mobile X-ray services to enhance patient care and reduce healthcare costs. Future implementation should focus on reducing repeat imaging rates and addressing logistical challenges to optimize the service's effectiveness in different settings. Ongoing monitoring and staff training will be essential for sustainable service delivery.