Obesity is a growing medical problem which can influence the ability of radiology department to provide optimum image quality and accurate diagnosis. This paper will address the economic and quality care impact of obesity on the ability of radiology departments to provide quality diagnostic imaging.
METHOD AND MATERIALS
A fourteen year retrospective review of dictated radiology reports with the disclaimer "limited due to body habitus" between the years 1989-2003 was performed from the electronic medical records. Percentages of "limited" radiographic studies were calculated per year. "Limited studies" were also classified based on modality and percentages per modality per year were calculated. Comparisons were made of the calculated percentages between modalities within a year and within each modality across the 5 years. Economic impact was assessed by calculating the cost estimates for the limited studies on a per modality basis, per year. Quality control issues were accessed by examining what technical factors and patient factors resulted in the limitations for each modality.
Overall, 0.15% of all studies were limited by body habitus. For all studies from 1989 through 2003, there has been an increase at a rate of 0.010% (95% CI 0.007-0.013%) per year (P<.0001). The study most dictated as "limited" is the abdominal ultrasound, followed by chest radiograph. 1.5% of ultrasounds were reported limted by body habitus. The rate of US cases limited by body habitus for 1989 through 2003 increased at a rate of 0.090% (95% CI 0.045-0.134) per year (P<.001). 0.08% CXR were reported as limited with a increase at a rate of 0.007% (95% CI 0.0008-0.013)per year(P<.05). Although the direct economic impact of the "limited studies" is small, the steady rise over 14 years and the additional diagnostic tests and increased hospital stay to make up for the "limited study", also has an economic impact. A review of quality control shows technical factors available for each modality to improve image quality in obese patients.
Changes in the American body habitus over 14 years has increasingly affected the ability of radiology departments to provide quality images and accurate image interpretations.