Association Between Physician Age and Imaging Utilization in Emergency Department Abdominal Pain Evaluation

Background

Emergency department (ED) workup of abdominal pain commonly utilizes substantial healthcare resources including laboratory tests and advanced imaging. Although studies have explored various characteristics that influence resource utilization, the relationship between physician age and use of imaging modalities is unclear.

Objectives

Determine the correlation between physician age and ordering of abdominal imaging in the ED.

Methods

We extracted data from 5 years of patient visits across multiple EDs. The primary outcome was use of abdominal imaging, with secondary outcomes of hospital admission, ED length of stay (LOS), and 72-h revisits. Multivariable logistic regression was used to assess binary outcomes, and multivariable linear regression was used for LOS. Physician age was categorized into cohorts of <36, 36-44, 45-54, ≥55 years.

Results

Evaluation of 91,922 unique encounters revealed that the most senior physicians had lower odds of ordering imaging than younger physicians of any group and had lower odds of 72-h revisits with no difference in admission or ED LOS when compared to physicians <36 years. The middle groups (36–44 and 45–54 years) had higher odds of hospital admission than the youngest. The 2 most senior groups had lower odds of 72-h ED revisits than physicians <36 years.

Conclusion

For patients presenting to the ED with abdominal pain, more senior physicians utilize fewer imaging resources, have fewer 72-h revisits, while maintaining equivalent hospital admissions and ED LOS as the youngest cohort of physicians. Further research is needed to discern what specific features of senior physicians contribute to the associations highlighted in this study.