Double Chest CT Scans Persist, New Data Show

Hospital use of double chest scans in 2009 barely changed from the previous year, despite clinical guidelines that say these CT tests should be used sparingly, according to newly released Medicare data.

In a double CT scan, patients get two imaging tests consecutively: one without dye and the other with dye injected into their veins. Medicare has identified the use of both tests on the same patient as a measure of overuse of medical imaging equipment, which is one of many reasons health care costs are growing so quickly.

The 2009 data, released on Medicare’s Hospital Compare website, show Medicare chest scan patients getting two CTs at the same time dropped only slightly to 5.2 percent of patients, from 5.4 percent of patients in 2008.

A total of 625 hospitals performed the tests on at least one out of every 10 patients using a hospital outpatient facility. That represented a fifth of the 3,121 hospitals whose rates Medicare reported publicly, and was virtually unchanged from 2008, when 618 hospitals performed the tests on at least a tenth of their patients.

More than 71,000 patients received double chest CTs. In 2009, 88 hospitals gave double scans to at least one out of every two patients. Blue Ridge Regional Hospital in Spruce Pine, N.C., had the highest rate of double scans: 90.5 percent of patients received one in 2009. That rate was a tiny bit higher than the previous year. The hospital told KHN earlier this year that it uses double scans out of extra caution, because so many of its patients work in the coal industry.

Other hospitals with the highest rates of CT scans in 2009 were: East Texas Medical Center in Fairfield, Tex. (86 percent); Avoyelles Hospital in Marksville, La. (83 percent); Memorial Medical Center of West Michigan in Ludington, Mich. (83 percent); Shanon Medical Center in San Angelo, Tex. (82 percent) and Marion General Hospital Marion, Ind. (81 percent).

jrau@kff.org