A Descriptive study of the family physicians' use of radiology in Barbados - abstract

ABSTRACT

A descriptive study of family physicians' use of radiology in Barbados was carried out. This study examined a total of 691 X-rays, a 10 percent systematic sample of X-rays in chronological order that were done on referral from primary care physicians in 1992 by the Queen Elizabeth Hospital's X-ray Department. Of the 691 X-rays evaluated at the Queen Elizabeth Hospital, 90.5 percent were of 6 types ( chest - 21.9 percent, lower extremity - 18.5 percent, upper extremity - 14.6 percent, contrast - 13.9 percent, spine - 11.1 percent, and head 10.9 percent). For all types of X-rays females were X-rayed more than males (overall 52.2 percent vs 40.1 percent, with no data on 3.8 percent). Forty-two percent (42.8 percent) of X-rays were abnormal, with X-rays of the spine most likely to be abnormal (66.2 percent) and mammogram (9.4 percent) least likely. No seasonal pattern of X-ray use was detected. Public sector referrals were responsible for 78.9 percent of X-rays and the private sector for 21.1 percent. These two sectors of primary care showed similarities in the frequencies of X-ray requests, by gender and result. For private sector referrals, 56.8 percent of patients were over 50 years of age compared to 26.2 percent for public sector referrals. Twenty percent (19.9 percent) of chest X-rays were requested to screen the patient, with 93.3 percent of these being normal, while of the 80.1 percent requested for other reasons 52.1 percent were normal. Most mammograms (62.5 percent) were requested on women under 50 years of age. For barium meals, 58.6 percent were done on patients over 50 years of age, and these showed a greater percentage of abnormal results than those done on patients under 50 years of age. This study provides a foundation on which further investigations of family physicians' use of radiology services can be based (AU)