Emergency callbacks due to imaging discrepancies ring up $2K-plus per pediatric patient

Over a recent eight-month period, children were not often called back to the ER of an academic children’s hospital in California due to discrepant radiology reports. However, the few who had to go back for a second look rang up additional charges to the tune of an average $2,289 per patient.

Danica Liberman, MD, MPH, and T.J. McCarthy, PhD, both of the University of Southern California, reported these findings in a study published online in Emergency Radiology.

The researchers reviewed the cases of all children who were imaged in the emergency department of Children’s Hospital Los Angeles from July 2014 to February 2015. Then they analyzed the cases that involved a callback prompted by a discrepant imaging interpretation.

They found only 207 of 8,310 cases, or 2.5 percent, had a radiology-related callback.

Of these 207, some 37 patients (0.4 percent of total, 17.9 percent of discrepant) had a return visit for further management.

Tallying indirect as well as direct costs—meaning not only ER charges but also time and travel costs to the family, as well as costs of radiation exposure—the researchers found these relatively few cases cost a total of $84,686.47.

The average per-patient cost was $2,288.82.

“Diagnostic imaging has mirrored the steady growth of healthcare utilization in the USA,” Liberman and McCarthy commented. “This has created greater opportunity for diagnostic errors, which can be costly in terms of morbidity and mortality as well as dollars and cents.”

While the overall imaging-based discrepancy rate among their study population was low, they concluded, “the clinically significant discrepancies requiring return emergency-department visits were potentially high-risk and costly for the patient, family and healthcare system.”